Public Health, Welfare and Labor Committee- House

Right here. Get one over it up front okay so please sign up if you want to speak on the bill. So we're going to get right into this So first bill on the agenda here is HB ten okay H. P. ten sixty seven represented Pilkington you're recognized. Percent of your recognized to present your bill thank you Mr chairman can I have. Some represent is from you a mess the company as well yes please haven't come up and introduce ourselves and who they represent. The members I want to remind you that only three mikes can be active at once so we'll be be sure to turn off you're Michael you're done speaking. Bill would introduce yourself and who you represent. Hi my name is Tanya Johnson and I'm the director of nutrition services and oversee the milk lab at UAMS. I'm doctor Mister Monte how many intelligence that UAMS in Arkansas children's and I'm the director of breast feeding medicine it both institutions. And I'm doctor Elizabeth cam I'm all seventeen intelligence that you M. S. and Arkansas children's and I'm the assistant director breast feeding medicine at those institutions. The Representative you're recognized thank you Mr chairman as many of you who are here in the last session sure you can remember when I ran my bill to establish rules to create a breast milk bank in Arkansas. After that legislation is passed and signed the law UAMS reached out to me and we started discussion about what needed to be done in order for us to create a breast milk bank here in Arkansas and so after that two years can peer discussion what I what came from that was house bill ten sixty seven so you see it's just a simple bill that would establish a breast milk bank created at the university of Arkansas for medical sciences. so what is this bill actually do this bill allows them to have the authority to create a press that bank. With you in mass and to create a fund to receive funds into it have granted this bill does not allocate any funds into the fun so this bill that we passed today will have no financial impact there is a nother bill that does deal with the funding mechanism but that will be in the rules committee on Wednesday and is completely separate from this piece of legislation so I just want to clear up any confusion there might be. So some of you might be asking why are we doing this what benefit does having a breast milk bank provide the citizens of Arkansas and as though you see from these one pagers that have been. Created by you a mass and pastel teal there's a lot of benefits benefits not only to the offense but to the mothers and as you know here in Arkansas we have some of the worst outcomes when it comes and then the maturity Health. So what are some of the benefits infants reductions in sudden infant death improve for nutrition. A reduction in disease risks especially when it comes to balance these press star tract infection diabetes and is also promotes healthy weight and young children. Of course they're also benefit some others as well reduction depression weight loss low risk for heart disease diabetes and breast cancer it is also significant savings that we can provide by creating our own bank here in Arkansas currently we export over eight hundred thousand dollars in funds to other milk banks across the nation. Not to mention because of us relying on out of state banks we constantly have a disruption in the flow of milk that we receive causing crises like situations in which were desperate for milk. So this bill will make sure that we pride prioritized Arkansas children so that they receive the mail that they so desperately need but also keep Arkansas dollars in the state of Arkansas while also potentially bringing in revenue from other states that do not currently have milk banks into the State of Arkansas as well. That's kind of the the quick. Explanation what this bill is but however I've I've guess here with me who I think would be way better than me and explaining the benefits and the reasoning for this Milbank to be created here in Arkansas. Thank you for having us today. for me as an intelligent and caring for very vulnerable population of premature and ill babies I see breast milk and donor milk as almost a medication it is that important to my babies it helps keep them alive because it prevents some very serious complications of prematurity like necrotizing enterocolitis that can lead to infant death in fact in our very low birthweight population somewhere between thirty to fifty percent of those infants who get knack will eventually die from their necrotizing enterocolitis and even if they don't die it adds hundreds of thousands of dollars to their birth hospitalization and to their ongoing medical care costs even after they leave the hospital if they survive their hospitalization. Supporting breast feeding for our mothers and our babies is incredibly important in our state we have incredible health disparities and inequities among some population of our state particularly in our African American population who has the lowest of breast feeding rates in the state. The health impact of not breast feeding following a pregnancy increases the mother's risk of having a myocardial infarction of having a stroke early in life and of dying early so it impacts not only her family's life in our society in her community but it impacts the work force and the health of our work force it impacts the life of her child because her child is more ill tends to go to the hospital more frequently has higher prescription cost higher position costs and higher long term health care cost even for term infants were born healthy. Having a milk bank in Arkansas not only keeps our healthcare dollars in the state but it means that the donor milk that we get from our mother's stays in Arkansas and is prioritized to our Arkansas infants which is incredibly important will help ease some of the problem problems we face when we run out of donor milk and not being able to continue to feed those babies in the way that we know is scientifically based and healthy for them. It will also give us a voice as UAMS as representatives of the constituents in your state to say that breastfeeding is important we support breast feeding in all its forms we're going to help moms do what's healthy and right for them and their family thank you. And I would just like to add that overseeing a milk lab at U. M. S. I. see the struggles that we have to deal with from time to time in obtaining donor milk we have to go outside currently we're getting our milk from Michigan and if Michigan has and run on babies in their Niki that need milk then we're last on the priority to get that then we have to struggle to call around to various milk banks to try and you know procure that milk and once we do find it takes a minimum of forty eight hours for us to receive that shipment in and so with that happening there's many of these for real infants that we're having to switch from donor breast milk to a formula until we can get that milk back into our facility so the logistics of having a milk bank here in Arkansas would not only help us to prioritize for those infants here in this state but also those moms who at. Pomp and collect breast milk and then they lose an infant they've got nothing to do with that milk and it's a very heartbreaking for a lot of those mothers to have to pour that milk down the drain when it could go to save another infant in the state so if we had a milk bank here in Arkansas that vital milk could be utilized for other infants and save other people's lives and give those moms as sense of you know. Priority in a sense of you know relief that that what they did that the loss of their baby help save another baby's not complied with organ donation it's very similar to that so you may have lost your baby but all the milk that you collected can go to save another baby so I really feel strongly and having a milk bank here in Arkansas just from what I've seen at UAMS in trying to procure the us product for our infants and then also for those mothers who've lost an infant and who would like to donate that mail the struggles that it takes to donate milk out of state is really it it's a complex situation and we could really you know stream on that and maintain a lot of that product here in the state of Arkansas. For. All right. Represented glad you're recognized for a question. Thank you Representative Pilkington and ladies for bringing this up for just one question about the safety of the breast milk you know drug free and things like that would you just expand on that just a little bit force thank you. Absolutely breast milk donation is one of the most stringent processes that you can go through and donating a bodily fluid I would say it's even more stringent and donating blood the mothers are screened initially to make sure that that both they and their newborn at home are healthy are getting adequate if milk and nutritional intake and are safe to donate that excess milk without shorting their their existing child once that has been established medical records from both of their position from the pediatrician on the insta obstetrician or obtained and screen to make sure that mom has no other health conditions that are contraindicated in to donation once the milk is obtained it is screen for multiple different infectious diseases bacteria viruses and fungi it's also screen for known drug exposure and some other medication exposures. Once it goes that screening process that that's accepted it is then put through a pasteurization process that heats the milk to make sure that any existing non non scary bacteria or viruses like you know the things that exist on your skin are killed in an activated so that the milk is and rendered safe for feeding to premature infants. We we have to develop like a feed safety it's it's very similar to other food service operation so we develop a food safety guideline and pass that program and so we make sure that we follow all those programs and everyone is trained and in appropriate sterile outfits when they handled milk. And that procedure exist both in our milk lab and would exist within this human milk bank there's an accreditation facility called human milk bank association of North America that would that after we establish our protocols would give us an accreditation to say that we are an accredited facility and have safe food processing and handling techniques. The represented Bentley you're recognized. Thank you Karen thank you so much represented bill camp bring this bill for the latest thank you for being here today can you just elaborate on the fact of how breastfeeding brings life on how this benefits throughout a person's lifetime not this is an infant but it really is truly a lifelong I think so my colleagues may understand may not understand it but it also as we look at Arkansas as we're going to this covert crisis we can see that are higher rates of hypertension and diabetes and cancer and obesity in those things are really cause us to have a higher death rate those those folks are the ones that really had for what comes from this certainly relations and labor and how brings lifelong health as well as helping our infants thank you. Absolutely I hope you have four days because I can talk for a very long time for mothers particularly and I think we talk about a lot about the benefits to infants and I'll get to that for mothers in particular breast feeding helps reverse some of the changes that happen during pregnancy pregnancy if you want to think about it is a sick internal logic stated developed a whole new and different organ to feeding grow a human fetus inside her delivers fats and delivers glucose in order to grow the cells and grow the baby. This essentially makes are metabolically sick and the moment she delivers the baby that does not reverse that entire process that occurred over that ten months breast feeding is the process that reverses those changes in her integrins system it helps reduce her risk of stroke going on through her life and for African American women if they breastfeed for thirteen months total in their lifetime not just with one child but total over the course of several children it reduces our risk of stroke by almost sixty percent which is astounding and that's the biggest reduction in stroke risk that you're going to see for any medical intervention in a female stroke is one of those entities that unfortunately disproportionately affects women over men causes loss of life earlier in life and also disproportionately affects or African American population and breast feeding is the one thing that we know can help reduce some of those risks it additionally reduces her risk of myocardial infarction and very importantly her risk of premenopausal ovarian uterine and breast cancer so three huge killers of women early in life that because a lot of health care cost lot of missed time from work in loss of life and loved ones. For instance breast feeding for prolonged periods of time particularly at least two months and ideally as much as six months of exclusive breastfeeding reduces the rate of sudden infant death syndrome so loss of life in the first year of life breastfeeding for six months exclusively can reduce the risk of sids death by as much as fifty percent in Arkansas we have prioritized breast feeding for that very reason because our infant death rates in the first year of life are amongst the highest in the nation. It also helps reduce risk of severe asthma and allergy hospitalizations for related to respiratory and GI infections and it can additionally reduce the risk of childhood cancers like leukemia and lymphoma and there's nothing else that you can do for your child that's going to reduce the risk of getting cancer in childhood except breast feed. Thank. The represented person recognized. Thank you Mr chairman of another it's a milk banks some of the milk is donated and some of it they pay like a dollar an ounce or something like that do you have any national statistics on how much is donated and how much is paid donation. The human milk banks of association of North America is a not for profit we do not pay mothers to donate their milk they do it out of the goodness of their heart after it has been screened there are some milk banks and milk processing labs call prolactin Metalac that are for profit companies that do pay their mothers small amounts of money for their milk and that's not something that we accept currently at UAMS except in very small amounts because it's a shelf stable product but the bill bank that we are proposing would not pay mothers that would accept donations okay thank you. Resented Boyd you're recognized. Thank you Mr chair. I think I missed something and I just need some clarity to help dot the I's and cross the tease you're throwing out a lot of great statistics I'm a firm believer in and breast feeding but we're talking about a milk bank so help me understand how the two are connected pretty please. That's a wonderful question for premature infants when a mother cannot provide her own milk clearly I prefer to get mothers own milk from an immunologic standpoint mothers own milk is far superior to any other type of infant feeding but when I can't get mom's milk because of a medical condition or a medication that she's on or an infection that she has we use donor milk to bridge that gap so that I can feed them a safe nutrition a safe source of nutrients that does not cause harm to the intestine is bovine based formulas do. So for very vulnerable babies and those who are very ill in the first several weeks of life those who have immunologic deficiencies we prioritize donor milk for those infants so this would be the priority of that that answer your question Sir. The represented not so you're recognized. Thank you Mr chair Couple questions regarding the the process this is going into a bank by donors is not going to be used strictly for infants at UAMS or will this be contributed out else out work outside of that will be sold or is it going to be just purely giving away that so basically with when we establish a milk bank it the priorities for the state of Arkansas we have three level three Nick use here in central Arkansas and then there's Nick use in Northwest Arkansas Jonesborough Fort Smith and then other hospitals that may require this so it would be received by at UAMS the milk would be received their process then we would have that available for the other knee cues it would there is a fee associated for other area hospitals to get the product but that's basically to over you know to cover your overhead as far as the labor that it takes to pasteurized process and then dish disseminate that milk is so it is non profit it would be a nonprofit agency but there would be some fees associated from other facilities to help cover the overhead of the of the processing so the read the reasonable fees that are mentioned in the bill are what you a message charge another facility for receiving that properly or they would. A outs to anyone for donating the milk it would only be for the overhead cost of at the the pasteurization and the processing and distributing process and incentive Dotson they're already paying those fees out of state correct things so it's not like this is a new fee that they're gonna be paying instead of it going to milk making Michigan it's going to milk bank here in Arkansas keeping the dollars here okay thank thank you I think that clear enough for. Resented Allen you're recognized thank you all for bringing this bill just very quickly what we normally what is the average fee associated with this. Thank members just arrested fee associated with that purchasing donor milk you're a mess bins roughly fifteen thousand dollars a month and donor milk to to either hospice of Milbank in Michigan or one in North Texas at two we typically purchaser milk for hours about fifteen thousand a month thank you. All right seeing no further questions from committee knows or anyone in the audience who wants to speak against the bill. For the bill. Seeing none represent the rate close to bill. I have a motion do pass a discussion on the motion. A single discussion all in favor signify by saying aye. All opposed nay moshing carries. Your Representative bills passed. Good represented Pilkington you might as well stay there. The Committee the next bill is HB ten sixty three by representant Pilkington. And the committee there is an amendment. to this bill. I have sent to you. So represent if you want to go ahead and not present your amendment. Sure SO what feels Curley passing out is an amendment we are adding to the bill I don't have in front of me but I believe it it deals with section G.. What happened was Schools that come to me worried about being able to provide some of the servers they do through telemedicine currently so the language that the medical record had to be capped by a physician or healthcare entity and they just wanted schools to be included in that as well Thank shopped around and seem to have any sort of issue with that change they were just concerned that they might with this bill being passed be suddenly locked out of being able to provide the services they do through school telemedicine so that is the reason for the amendment. With will committee resent Payton. I have a motion I'm sorry. All right have a motion to adopt from Representative Payton and discussion on the motion. Seeing none all in favor signify by saying aye. All opposed nay moshing carries amendment is passed you're recognized to present your bill as amended thank you Mr chairman today what I bring to you is house bill ten sixty three an act to amend the telemedicine acts As you know to the coveted that. The playing field in Arkansas's change when it comes telemedicine environments changed. The executive orders done by governor Hutchinson I think have expanded telemedicine in an appropriate way and so we're looking to do here with this piece of legislation is to turn that into law after the state of emergency goes away. And so what we've done here is added a few guard rails one of which I believe at the very end being on section four or section five part four Requiring that insurance companies are not allowed to prioritize a telemedicine visits over a in person visits essentially your insurer could not say we have to go through telemedicine before you go see your local hometown doctor the insurance companies are fine with this change provided for by with changes merely safeguard that we wanted to put in place that wasn't in the executive order that's really it the way we've been practicing telemedicine under the executive order at this just makes a law that's it. All right any questions from the committee. Representa Eubanks you're recognized. Thank you Mr chair Representa O. intended the it was my understanding that the in order for the patient and the doctor. To have a relationship they had to be have a person in person but then it looks like N. G. it says is this relationship can be established over the telephone is that accurate correct and its relation can be status over the telephone Only if they have access to the patient's medical record and that's also just the once again a safeguard to make sure that the provider has access to all relevant health data by having that patient's medical record you think there might be any ambiguity there but with the one rules are started to be promulgated that might go contrary to this thirty thank everybody understands the intent of your bill. I think the intent of bills very clear and I'm glad you brought that up represent Eubanks the this legislation is to allow our Kansans access telemedicine In the most convenient way possible for them and obviously sometimes the telephone is a more convenient way to access telemedicine as opposed to a virtual audio visual setting. Vaught Mr. Yes with the with the medical board be the responsible entity for propagating the rules does my understanding yes. Mr chairman is there anybody from medical board here. Twenty one for medical board the audience. Please enter this yourself and who you represent. Your partner help for the medical board. Mr Gilmore do you think there's any ambiguity here that my calls rules to be promulgated that might not follow the intent of this I haven't heard any I thought the medical board haven't heard those concerns or issues so make a one world one rules promulgated income there are rules and regulations committee the only way we can deny approving them is either they go against let legislative intent for their unconstitutional so I don't want any any. Problems when any rules come do that committee understand of you know I think we will I think the board will try to follow the the intent is is as well as they can I know you know. Rules can get interesting sometimes I think the and I think they will fall the intent that will be what we tell them to do. Thank you thank you Mr. Senate Peyton you're recognized. Thank you Mr is real simple Aussie added a paragraph one G. that requires the healthcare professional to be licensed in Arkansas yes Sir and I appreciate that because some of the concern was whether would degrade our availability of physicians and stuff in Arkansas. To be licensed in Arkansas today after practice in Arkansas could that be. Licensed in Arkansas no. Bank somewhere else you can be licensed in Arkansas but do not have to practice in Arkansas and so you know you could be you could be a doctor who's got maybe a clinic in Mississippi you're right over the border and you see patients from Arkansas but you don't have to practice but this is I mean thanks at that part section G. a healthcare professional who is licensed in Arkansas and as access to a patient's personal health records I mean that's you know we want to make sure that we're using in Arkansas all providers I mean the last thing we want is our. Arkansas dollars going to pay for a provider in San Francisco or Miami or something like that because they've got slick ads and we you know telemedicine's a great tool for bridging the access gap and rule Arkansas but we wanna make sure that we're not doing a situation which like you said dilute our our provider partners because I mean there are things you know I mean trust me if you're you know if you're out honey she just of the foot Thomases and do much for you you're you're gonna guess doctrine person so you know it's it's just part of the. Part of the network or making dens client access thank you thank you Mr. Represented Wardlaw you're recognized. Thank you Mr yesterday you and I had a discussion about the The Amendment and those records will be maintained in the purpose of amendment was not to require the school systems to maintain those records but the providers themselves which will make this clear on record they still maintain those records Jr yes they still maintain those records it is adding schools is being a list of. Listen as their sanctions that they'll have those records is from my understanding it's just you know school is considered a health facility our our doctor's office exactly it up yes Sir okay I just wanna make sure we got that on record thank yep sorry about that. Resented Boyd you're recognized. Thank Mr represent okay to just clarify for me is it true that the laws that are apply with telemedicine in so if you have a physician and say Oklahoma right across the board border and Roland talking to a patient in Arkansas in that case the the laws apply to where the patient is located not to wear the provider is located correct thank you. A committee any further questions. center Dotson you're recognized. Thank you Mr I'm just trying to I'm still wrapping my brain around this amendment and the personal health record and it this this may be. This may be for Mr Gilmour more so. Just as far as what. The medical or the health department's view of the legislative intent of this personal health record actually is in your your opinion what do you read this to mean. Back in one of our health represented can you point to where you're told the H. two line fifteen the item G.. Healthcare professionals licensed in Arkansas and has access to a patient's personal medical record. That is maintained and then The Amendment begins there. By a physician or other licensed healthcare professional or local educational institutions using real time interactive audio technology including the telephone. So that personal health record. Who. How's that what's the definition of that. According to the legislative intent in your opinion. I do not have a. Good answer for that to be honest with you I think it would be I mean we would interpret it to be written as the or to be interpreted as the law says I mean they have to have access to the record I mean it and I think we would anticipate that that would be a They position would have access to the records I mean look when the board right to the rules this will be what they go by and we will we will instruct them to follow that as closely as possible. But I guess. If they're if they're making a call over the phone who has who is the a healthcare provider what what record are we referring to is this I know what I'm going to the doctor the fifth of dots and I want to recognize represented Ferguson to make she can't yet if I can have a point of personal privilege at because I wrote the original telemedicine bill of the medical record is not set in the patient feels at them sales the medical record is something that is an exam that is done by a physician or an a priori and. So. Record access to the medical records is not of patients demographic form that they fill out and see and because of many times patients don't really understand what medicines are on their own medical history the more we wrote the original telemedicine bill we said that you could establish that relationship in do that exam audio visual what the emergency order did was expand that to say you can do a telemedicine visit and establish a relationship but because it's not visual that that that is just a phone call of the you can do that by the phone call but you have to have access to their medical records that means either that you previously seen them as our patient or someone can electronically C. G. that medical records because a patient feel that demographic form is not a medical record the other thing I guess I have a question for represented Pilkington if I might of. I want to clarify this budget isn't just a phone call that a doctor's make it to a patient for a consul. It has to meet certain parameters of the PCP code to establish it as an office visit to be charged is that is that right it's not it's not doctors make phone calls all the time but this is a phone call telemedicine visit which means it has to meet certain guidelines on the PCP code to file for payment that's correct Not to get too deep into hospital billing but there's certain criteria that need to be met like you said to take. To use a certain CPT codes you need for billing so yes simple. You know Hey doc I bumped my head you know should I come in now and hang up that's not not the call by the visit you can't get paid for that so it has to meet the secretary that they're already meeting To do a dog you know like an audio visual there's like you mentioned they have to meet certain criteria they want to build certain CPT codes and they have to follow those that doesn't change any of this. And I can still under the old telemedicine law establish a relationship audio visual and I have never seen the patient before or had the medical record it doesn't change that it just adds this additional phone call office visit charge that stable under the emergency orders that that's correct so for instance let's say patient has an audio visual appointment with a provider and then you know they they go do it somewhere else then they're in a situation where they don't have the ability to use the internet they can only call myself on your correct they've already establishes that they've already created a medical record with that provider so using this law. They've got complete free range to to do that I guess I just wanna clarify you're not overturning anything I previously has to reflect. You know just expanding. Representative Johnson the year you're recognized again did you still have for those questions yes I just want to be clear at as I'm trying to understand this in the in the situation like. You know if you haven't been to the doctor and for five years and so you don't necessarily have a quote on quote PCP the G. use it regularly but you need to go to the doctor can someone make a phone call and that the establishment of the record or can you have your your old doctor send you the the health record and get that to the new when you're calling in under this so the second scenario so let's say you're someone you live out in the middle of but just say Knoxville Arkansas where I live. And then the doctor for five years and you don't have access to zing are you know any sort of have a compliant audio visual equipment our program. You could put say you saw you know these are doctors ten years ago Miller Henry you can just have to call them up and say can you please send that file to this provider because I'm going to have a audio call with them and once and and you can go and have that audio call without any visual components and be perfectly fine okay so that that's the intent of that are you read it that's why I'm vision I guess or okay thank you. Okay committee any further questions. All right we do have one person signed up to speak against the bill thus the Brighton here in the audience would you come for. And introduce yourself and who you represent. There we have. Good morning Mr chairman my name's dusty Brighton I'm here on behalf of one eight hundred contacts you're recognized thank you Sir. Reshape the opportunity to be here this morning Mr chairman for the committee I represent one eight hundred contacts and they are they certainly I appreciate the opportunity to speak today and certainly appreciate the spirit of Representative Pilkington's bill there certainly fans of expanding telemedicine capabilities however at this time with the bill in its current form we've visited with representatives in today's been good enough to speak with us as well as by share Ferguson but there seems to be some question right now one hundred contacts is able to operate in the State of Arkansas due to the governor's executive order they were not operating in the state for that there seems to be concerned with the way that this bill as written even though it does expand audio visual I'm sorry audio only capability either to suit does seem to be some question if this bill passes and the executive order expires if one eight hundred will be able to operate in the State of Arkansas this is that due to some of the language that is already been discussed herein question here in the committee here today and with that I'm I'm glad to take questions on which sections of the bill may be affected. Represented Ferguson recognized. I'm trying to understand how you would do an uptime injury exam without visual. Well I think that comes from the patient's history hi I think we telemedicine right now you're able to provide care the audio visual through the website. Well that's of saying audio visual is not a part of this bill that's already allowed again it goes back to some of the the roulette definitions with regard to the professional relationship and patient generated history that's that's part of the concern the attorneys it what a hundred or looking at it seems there seems to be some at another ambiguity there to. To establish a question. You're recognized. Thank you Mr. Well tell me one eight hundred contacts operated in Arkansas before the pandemic so as a as I understand it they didn't so people in Arkansas could take their prescription. And. Go to their up to their optometrist or the ophthalmologist and they get a contact lens prescription and they can mail that to one eight hundred to go online and they can back contact lenses they did that before what are they doing different now I think it has to do with the establishment of the website when I ask the question if they were operating before the so I was still they did not they did not while they did before I can tell you that they did on an ophthalmologist and I know that they did so I don't understand why this affects them what are they doing different now that that that they're going to be cut off from doing that they couldn't do before again it goes back to the definitions that are in this bill and the extension of the executive order but will not be still not answer my question what are they doing different fragmented did before glad to talk to you off line about that with their term so you're and you're and you're in a committee meeting and we're trying to decide on the bill and I think what they're doing now what I've been told is they revealing contact lens prescriptions that have been expired that patients are calling in and they're going on line and and they're reporting they're not having any problems and one eight hundred is revealing those prescriptions there's not an optometrist or ophthalmologist in the State of Arkansas that a refill a prescription for a patient that tennis for expired prescription there's a reason they have people come in many times patience this for your information for them information the committee many times patients your work contacts and not having any problems in their prescriptions expired and they'll call the optometrist office for the ophthalmologists office in this state okay we'll give you one more refill but no more because you need to come in and have an exam they may not be reporting a problem but they need at least a yearly exam and and depending on what the provider things that may need more than that they may only give three months for the contact lenses people can have I related issues that can be very visually threatening that you cannot diagnose. Audio visually you have to put him at an exam in the chair with a magnifying slit lamp to look at their at to see if they're having issues so I don't understand what the difference is in what's what one eight hundred contact is trying to do. Thank thank you Mr. Ninety for the questions from committee. Missing on thank you for your comments thank you very much does anyone in the audience who would like to speak for the bill. Against the bill. Senate representing the radicals free bill. I'm close for a bill on a motion to pass. And as amended thank all right we have a motion of do pass as amended any discussion on the motion represented McGee you're recognized. Thank Mr other for community command Representative to bring this fall and I think that it expands access for patients and for the committee when he talked about the city CPT codes you can't fail for code unless you do an exam and and and for the higher level of code you have to do an in person exam so you're looking at. The example of the codes are like one through five of five is the highest level you have that has to be a complex issue personal exam extensive history and all that sort of thing so I think it's a good bill it's going to expand access for patients I've been impressed with what they've coverage done anything it's brought forth that we can use telemedicine to really help patients I mean I used in my own practice now or I didn't before people send me pictures of their act we had a well I better not say who it was because of patient confidentiality but we had a Representative who called me and said I'm having this I issue and this will take a picture of it so I took a picture and I said we need to look at your at well I don't need to just to give you something over the counter we need to look at you any committee had a very serious eye problem so I think it's great then I commend you on your bill represent fifteen thank you thank you Mr. Any further discussion. Okay the motion is do pass as amended all in favor signify by saying aye. All opposed nay moshing carries graduation bills passed. The next on the agenda we have S. B. seventy eight Representative lance. Represented you're recognized to present you will represent the Roger Lynch the district fourteen that and if I can I'd like to invite to colonel don berry retired U. S. Air Force to the table yes come on up. And the please introduce yourself and who you represent here here representing. Thank Mr done very with the Arkansas veterans coalition and it was on behalf of the occupational licensure advisory group that worked on the legislation. The Representative recognized presenter bill. Hi Senate bill seventy eight is modifies existing law around the licensure of unifier of of uniformed service members when they transfer in the state their spouses come with a lot of time their spouses are teachers they're nurses they're other professional license people what this bill does is it helps clarify the what's required for them to be able to transfer their license and be recognized in the state of Arkansas and it also adds the army reservists and National Guard that may be transferred into the State it covers their spouses. Tell us to safely what the bill does. Sir I appreciate very much the the the committee's opportunity to present Occupational licensure is a huge issue for military families who transition from base to base to base and having to get a new license for their spouse typically on those moves for example my wife's in R. and it one point time she was holding a licenses in five states because once you get a license you never let one expired because you may go back there because of the time it took to be able to get into a license. since twenty thirteen Arkansas has been working forward to resolve these issues we had legislation on thirteen fifteen seventeen and nineteen session which it really raise the bar we're show your quick picture. I would not see too well in the back but there's only four states on the map here they're Green Texas Virginia Indiana and Arkansas. We are able to at that point time. All of the four occupation licensure Initiatives that DOD has asked for or or are met by our state and thanks to this committee and and this the Arkansas legislature over the last sections ACT eight twenty and then twenty nineteen session co chaired or co sponsored by represented Bentley really raised the bar nationally with an automatic licensure provision what this bill does SB seventy eight does it resolve some problematic language with SP seventy eight that was from previous edition of the statute which called for substantially equivalent as the term that of comparison between the license the the holder was held and the Arkansas Plaisance. in Arkansas we treated that as being related to the scope of practice for at least practice act is how that was related to but in other jurisdictions. Actually at the federal level they said that substantially equivalent meant the steps the preparatory steps the schooling training education or experience as the as the leveller that was not our intent this bill fixes that by directly relating it to the scope of practice Page six line thirty in that section there are talking about necklaces your addresses that the other provision as represent Lynch talked about the model language originally from the DOD call for a expedited licensor for active duties military spouses and veterans within a short period of time after their transition. Active duty military is army navy Air Force marine corps and now the space force. doesn't include the Coast Guard doesn't include the public health service does not include no it does not include the guard or reserves. as we are turning the page to as this process going on from thirteen we realized we have an opportunity here in Arkansas to be able to expand our work force capabilities so couple of the provisions that we changed and in this legislation here was to apply it so the for a traditional guardsmen in this picture you have in your mind is say a guardsmen named Colorado's a professional engineer and their spouses a pharmacist under the current statute they would not provide any expedite they would still go through the whole long process to be able to get re licensed in Arkansas. Unless they're covered under compact. With this be seventy eight that Arkansas that the professional engineer who happens to be a traditional guardsmen in Colorado who was offered a position in Arkadelphia is going to be able to be served with this be able to expedite their move to to Arkansas as well as the spouse is covered as well too so is the strengthening of the of our licensed workforce in Arkansas we made some other amendments to the provisions to the and in the statute structurally you probably saw this is somewhat different what we did is we took a code section that was getting quite long and complex and we elevated up to eight chapter status to make it much clearer but I want to thank actually a one one of those initials co sponsors of the original legislation when we. Back in twenty thirteen when we made our first step towards the occupational licensure path by which were on their. And. Represented Perry was on that at that time and and was co sponsor with the center agent Williams that's how we started this past I was a thank you mark but to also to this committee very specially has been very strong advocates on behalf of military families we were much appreciate number bill for questions. Represented Bentley recognized. Thank you for answering my questions alright I understand why we had what changes are willing to make and why so thank you very much for bringing this for today and we can do to help our military families would ever need to do so thank you. Any other questions from committee. Represent a person recommended I I guess they may maybe say this but that I didn't quite understand it what what exemptions are we making from state law and licensing a C. like they don't necessarily have to have continuing ed they coming what what are the exemptions. They were making for them that are not required by law to read license or an excuse me ma'am if if or or a renewal of an Arkansas Lysyk we've issued them a license. through the automatic process or an expedited process which the rulemaking does provide for and there's a review of that regard through the A. L. C. that does review those for expedited the the. The default is an automatic license if Indiana has gone through the structural efforts of reviewing my credentials to be come out of a practice certain a professional in that regard if I'm holding an Indiana license and I'm a military member under this part of the applicable that Arkansas of simply recognizes that Indiana licensing issues me in Arkansas license but when I come back for a new will I have to meet all of the stipulations for that renewal so I would have had to been in good standing in Indiana. Before I can be eligible in Arkansas. I guess my only concern you know there there's a lot of difference in state regulations and if we're if you're gonna license in the least restrictive state sometime that may not be in compliance with Arkansas law but you're saying after renewal they have to make the state required guess I'm trying to understand and when the renewal you'll be you'll be in Arkansas license holder you're gonna have to meet Arkansas requirements for that the renewal of that license. The automatic license provision actually is the is was that was a result of S. B. five sixty four ACT eight twenty in the nineteen section so we've had that already on the books we've the the L. C. S. subcommittee has been met for a year reviewing entities The licensing entities had to come before them to explain their process as to how they would do that but in all cases what we found was that The scope of practice which was which was a much better measure of to compare rather than what with the preparatory steps for you to get that India license so what we're looking at is what the scope of practice is or the practice active for that particular profession. I'm not sure I think I'm. I just wanna make sure that when they moved Arkansas they have to comply with Arkansas scope laws and all other provisions of Arkansas law yes ma'am and then on renewal they have to meet the standards for licensing for the state is that right yes ma'am and in fact when we make the provision as applicable to the scope of practice the Arkansas scope of practice for that profession maybe more restrictive than the scope of practice was in the previous state they are they are held to the Arkansas scope of practice Arkansas scope of practice may be more advanced than that other state if the. Professional comes in Arkansas with that gap with this statute now would be provided them if the if the if adopted would give the state the licensing entity the authority then to require training to fill in the gap between what the credential I the training I've got and what I can do but the basic licensure would be you is provided for. Thank you. All right saying no further questions of the Representative you're ready close for you bill I'm sorry was there anyone in the audience who wants to speak against the bill for the bill. C. ninety ready close yes yes I am. What will the committee represented Dobson. I have a motion do pass by represented Dotson any discussion on the motion. Represented Gonzalez you're recognized. Thank Mr I think this is a great bill and I'm going to vote for it but also believe that if we can do this safely for military members will look at expanding this out to to everyone it I don't think you're being a spouse of military members gives you any special. Your knowledge that anybody else would have this licensed in another state so I would like to see this expanded on to to all. All people thank you thank you for bringing this. Represented Ferguson you're recognized but just and comment to represented Gonzalez at you know I think a lot of times you have to be careful about disciplinary action and other things and other states which you may not recognize is as often it was just an individual moving from state to state to practice the military has a much tighter control on those kind of disciplinary issue so. Any further discussion. That. Okay the motion on the floor is do pass all in favor signify by saying aye. All opposed nay moshing carries congratulations representing bills passed yes thank you Committee. All right the next we have H. B. eleven forty represented grey's going to be presenting that bill. Personal Representative recognized Lynch bill. Thank you Mr chair. So house bill eleven forty AM an act to modify the law concerning embalmers and funeral directors and for other purposes fairly straightforward of agreed upon bill to my knowledge is kind of a clean up allowing for licensure as funeral directors to complete twenty hours it allows for it not just on site instruction but also for virtual method of instruction. Kind of catching up with the century and then it also allows for. Notice that's required for construction of a crematorium is amended to allow that the publication is sufficient if it's published not only in the print edition but also in a digital and digital edition and then I think there was one typographical error in statute and so that that word was stricken and then corrected as well so that's essentially the three things that the bill does I'd be glad to take any questions and also had people in the holding room available for questions as well. All right committee any questions represented pair you're recognized thank you Mr chairman Representative great how often is the twenty hours required. For education. That I do not know could I ask for a mandate Gibson to come. Brownwood acres works as well thank you. If you would introduce yourself and who you represent. Kutcher my name is Robert acres I am the director the funeral services division and the prepaid funeral benefits division with the Arkansas insurance department and effective July first two thousand eighteen the staff so that supported the perpetual care cemeteries embalmers and funeral directors and burial services or burial associations transitioned over to the Arkansas interest department I've been over them since July of eighteen. To answer your question Mr In the two thousand seventeen legislative session Verbiage was added to require up to twenty hours of education for apprentices now. There were subsequent discussions by the new board and kind of a phase in period essentially at this particular point in time we are requiring six. A minimum of six hours of education for apprentices before they apply for their final application for the funeral directing or embalming so eventually I think that there had been discussion Among the board members and other people in the industry exactly how this education was to take place currently in the state of Arkansas there too recognized schools that provide general services type of education one is in Mountain Home and one is in hope we understood that for apprentices that are all across the state it would've been a hardship for them to travel to those two locations to get twenty hours worth of schooling to comply with that current law so. Yes you're recognized for follow up thank thank you Mr Akers so twenty hours is required how often. just initial right now it or pro here that was established for the apprenticeship program going forward once your license to be a fully licensed funeral director and embalmer I believe that the current requirement is six six hours of continuing education on a yearly basis okay thank you. All right representantes you're recognized. Of thank you Mr chair I guess the only question I've got this this provides for virtual method remote communication. it is for this twenty hours worth of stuff that. I guess how do you how does someone learn to unban virtually. That's a little different Marjorie school is required for people who are applying for a license to be in a ball so right now I think there aren't the same education requirements for funeral directors in the state what we kind of had to do is when we started especially with the onset of covered last year it was not a it was a hardship on these funeral homes that have brought in apprentices that are trying to learn the craft to travel to one of the very few locations to actually do classroom setting and so we've seen even in a lot of the conference's of happening in an interview in the industry over the last couple of years a lot of virtual classrooms virtual conferences things like that we I guess we kind of wanted to get things into the. That particular classes and actually the hands on embalming they do have to if they're gonna be in Barmer go to the trade school and and DO embalming and have a fully licensed embalmer supervise them for that so they've already been through all that this is just final pre licensure for the funeral director part of it I think that's the biggest part of it there is to give the option because right now the law is currently constructed and it says classroom instruction where you have to be physically present with the instructor and we just really in this particular environment now that we're facing The day just it's it's a hardship for the apprentices to travel someplace and actually being a physical classroom and so we're making of a similar to the students that are doing virtual learning from home. There are certain things that they can learn from home sure the rules the laws the practices and so forth like that and so being adding the virtual classroom setting to that law will help that thank you. Okay any further questions from committee. Seeing none is there anyone in the audience to speak against the bill. For the bill. C. nine represent of your clothes for your bill. I'm close thank you appreciate a good vote I guess I make a motion to pass. I have a motion of do pass any discussion on the motion. Seeing none all in favor signify by saying aye. All opposed nay. Motion carries resolution representing your bill is passed you're recognized to present HB eleven forty one. Thank you Mr chair. This bill is a little a little more lengthy so um fits all right now have Mr Akers sit here with me to help present this one and so this bill I tell you as I read through it for Representative ought to to present today I ended up having a few questions that I think I've got ironed out myself but just before I even start talking the title of this is an act to amend the cemetery Act for perpetually maintain cemeteries and that something that that that terminology was kind of new to me I think there's only been an application for a new one of these like maybe one in the past decade so it's this isn't for your everyday normal cemeteries for a specific type of cemetery so preface what I'm going to side with that It's needed this bills needed for clarification modernization and to promote efficiency it defines properly maintained it clarifies when applications must be made for a cemetery to change its boundaries removes a conflict between two statutes within the acts and it also modernizes certain provisions relating to a cemetery lands criminal background checks trustees and board funds so if it's alright I'd like to let Mr Akers expands on anything he sees fit with the bill miss records you're recognized seven comments thank you putting it in context perpetual care cemeteries in the state of Arkansas there one hundred and four licensed perpetual care cemeteries throughout the state of Arkansas. at the most recent I think there are over forty three hundred cemeteries in the state of Arkansas but the vast majority of those are either family owned privately owned whether it be a church a municipality or whatever and they do not fall under the regulations of the perpetual care cemeteries a lot of the proposed clean up in this bill one eleven forty one is to make the language a little more modern remove some of these House those their force and so forth like that some of the highlights what we have noticed over the last two and a half years since perpetual care cemeteries have been under my regulatory oversight at the A. ID is that the definition with regard to under twenty seventeen Teno two definition's number one. Care and maintenance it was a very generic description it didn't go into any detail of what that intelligence that you got to keep it properly maintain and we've we've endured quite a few consumer complaints of lack of care and maintenance and so we're just kind of adding a new level of detail to the bill to the the law under the definitions to say okay what we're talking about when we talk about properly main cemetery and so that's in addition there. There's also of what one of the highlights with regard to applications. The perpetual care cemeteries used to be administrator there over the oath under the oversight of the Arkansas securities department and when they transitioned over the Arkansas insurance department effective July first two thousand eighteen there were a number of changes that were put into the law back in the two thousand seventeen legislative session that swapped out referrals to the securities commissioner and they put in place The Insurance Commissioner now Insurance Commissioner is a defect a member of the newly created Arkansas state board of embalmers funeral directors cemeteries and burial burial services but technically the oversight of the perpetually maintain cemeteries is the board not the Commissioner so there's some switching out of language there to replace references to the Commissioner taking an application the commission being that this any other to the board so that's cleanup language there's of their as well. Are there any well the their definitions adding the term columbarium to a description of a cemetery a columbarium essentially is a structure with the increased prevalence of crematory and cremations that are now taking over traditional burials the cemeteries are putting structures within their operation call calling variants which will house the urns or the receptacles they have the ashes and so that was something that was in the previous law as well we're just adding it as an additional structure that would require an application for a change or bounty reductions so forth. I have a question and maybe I'm just confused here I don't see it in the bill but. What is the definition of a perpetually maintained cemetery to me that means maintain forever but. I mean why is this different than the other the the family and the city owned what's the difference well the deal is is a privately owned cemetery which again with forty three hundred and some odd cemeteries in the state of Arkansas being a family owned. We only have regulatory oversight over the one hundred and four perpetually maintain separate cemeteries in the state of Arkansas and typically you get to a certain size and a certain amount of income generated from the the deal is is the whole concept when perpetual care cemeteries law was created years and years ago is there wanted they wanted a mechanism by which money was put into a maintenance trust fund and that they were they signed a contract with consumer and they agree that forever and always they're going to maintain the cemetery grounds through those funds and so the the mowing weed eating the drainage the road replacement anything that has to do with the care and upkeep of the cemetery is built into the report showing is perpetually maintain cemetery contracts now when you talk about a little family and you can be on the widget can be someplace on someone's personal grounds it's small it's not it's it's maintained by either the family itself or if it's a municipality sometimes they'll have a board that will say okay it's your turn John John to go out and buy the Saturday in two weeks from now Mary's gonna do and so forth so we do not have regulatory oversight over the small family owned or our church owned or municipally owned cemeteries. Thank you. Represented a new recognized. Thank you Mr at the bottom of page seven top of page eight it's talking about a bond availability or surety bond and we're reducing the requirement on that bond can you tell us what the. Loss ratio is been in the past over there many claims what's going on with the bond We have had zero instances of bond issues. In the two and a half years that the perpetually maintain cemeteries have been under the Arkansas insurance department and I would say. According to my understanding of in this pretty it's my time having oversight over the cemeteries it may go back thirty years before the before we have a case where someone depleted the trust you know to find and I think we've got some operations out there that are large enough and they have so much money in the trust that having a proportionate or a hundred percent requirement for a binding for the person who has access to the funds either collecting the funds depositing the funds into the press and so forth like that I just don't see that there's exposure to require a hundred percent binding on those and eighty percent should be more than adequate because we haven't had any cases at least since I've been over in the A. I. D.'s oversight of instances like that who are suspected that and that's good to know you might wanna look into what Arkansas auctioneers licensing board did work they created a bond fund and related to members of having to purchase surely bonds in that field the state maintains that fund. Thank you Mr. Senate boy you're recognized. Thank you Miss thank you Mr chair five this this might be kind of a random question the last week you were here and enter your insurance and commerce this is this so it's like so I'm I'm confused are we working on health code or we working on some other code I mean is this a different part of the the statute is what I'm trying to understand this. My capacity last week if you ran on the Committee there H. B. twelve twenty six was Representative Cindy Crawford District seventy six out of Fort Smith that particular bill was something initiated by a Representative Crawford and it is to it's based on some consumer complaints that happen in the Fort Smith area with a couple of our perpetually maintain cemeteries Given what we were asking for that bill which I appreciate the committee last week voting yes to pass it as well as the vote on Thursday to pass it H. B. eleven forty eleven forty one or kind of enveloped into the department of commerce bill the overall bill they do touch on perpetual care cemeteries but what we did was the Bill H. B. twelve twenty six last week was deemed a little too controversial to include in our own lives there are big bill for the department commerce and since it was consumer initiated with one of the representatives it was run to do it differently but I am over the funeral services division which includes embalmers and funeral directors which used to be at its own Board burial associations which used to be its own board and perpetual care cemeteries which used to be its own board and those were handled and the Arkansas securities department until July of eighteen so there were just enough changes that we when we started trying to get language simplification and get at uniformity among various parts of the code most of the changes that are reflected in eleven forty one of our cleanup type items. That I think so okay. Ninety first questions from committee. Seeing none of anyone here to speak against the bill. For the bill. C. nine representing very close I'm close for the bill would appreciate a good vote. Make a motion to pass I have a motion of do pass any discussion on the motion. Senate none all in favor signify by saying aye. All opposed nay moshing carries the resolution the bill is passed thank you for. Thank you Committee. Representing gray you're recognized to present HB eleven ninety two I think there's amendment to that I want to recognize represented Wardlaw per statement. Mr and I just want disclose that I'm on the board of a triple a and I will be voting on this bill thank you for recognized. All right so committee there's a an amendment coming around. Represent if you want to start explaining your amendment yes thank you Mister chair I am so the amendment there two sections to this bill one section strikes language in the second section has legislative intent and this amendment strikes all of my legislative intent. All right members I give you a few minutes to look at the amendment. The are there any questions on the amendment. represent Wardlaw made a motion to approve any discussion on the motion. The motion is to approve the amendment all in favor signify by saying aye. All opposed nay Motian carries your member this past recognized to present your bill thank you Mr chair as I ran this bill last session for the first time and it made it through the house and I did not make it through the Senate with the bill I'm sorry brought it back this time around. with this issue he was brought to me by constituent who called so we've got the Personal care services and you have people that go into the home and and provide the services so I to constituent call you want to know why she was it re being reimbursed for mileage to you know the patient's home so as I started looking into it calling people I figured out that she was being paid as a ten ninety nine employee instead of a W. two employee so essentially she made so much per hour and she was required to work as many hours as needed to make sure she was paid a certain amount of money she was required to work as many hours hours as needed was not provided to you know the employer taxes weren't paid workers comp wasn't there there were no benefits no reimbursement for you know mileage or anything else. So that when I kind of came to light has started figuring out that wait a minute just a few companies in the state of Arkansas operate this way most of them operate and they pay through W. too so they're offered all of those benefits there is a little bit of a difference in pay between those that are considered independent contractors and those that are considered to be to employees so as I started looking at it now go into How the I. R. is see no they got some criteria is whether or not you're an employee versus an independent contractor and. Honestly last session I got into are you are you an independent contractor do I think these employees are independent contractors that you know essentially they're told where to go what today there's your clients you can choose from I'm not even saying that this session what I'm saying is these companies feel that they are following federal iris guidelines in that these employees or contractors they feel that they are following state guidelines and that these employees or contractors I don't see why they need except an exemption in law to allow it and I do I do not think they are I think this is a workers rights bill and essentially these these people that are working most of them barely above minimum wage deserve to have the same benefits at the rest of the people of the state are afforded whether that is workers comp you know the employer taxes be paid the possibility to have benefits such as insurance and get reimbursed for mileage so that's essentially what this bill is and what it does I'll be glad to take any questions and I think there are a few people here to speak against the bill today. As just as last time represented first and you're recognized. And this won't come as a surprise to you you know I'm opposed to the bill because I wrote the original bill that allowed the US. And so maybe I should ask it as a question the reason that we wrote the original bill Senator Ingram a nice because we had a personal care group in our district who was paying contract labor and it became a question between the difference in the law at the department of labor and at the department of health so we wrote this law to clarify that employers could choose to hire someone as a contract labor if that's truly how they were working can met the criteria of the R. S. so it was a clarification in the law because we feel like employers as employers have the right to hire someone as an employee or contract labor for instance these people going at a maybe fill it in on the weekend or any they were choosing their own hours and I truly met the areas criteria of an employee of a contract employee so I guess why would you not want to allow employers to have that option. I think if they say that they're contracted employees that are contracted employees in the State of Arkansas should recognize that is the same as the federal recognizes that I don't see why we need an exception to that if that's what they truly are. Well I'm just telling you the exception was required in law because there was a disparity at discrepancy between the department of labor definition in the health department definition so I would like to see this overturned but. Senate Miller you're recognized for a question. thank you Mr. Represent gray put it. How does this bill I'm. I've heard. A lot of negative and that also can understand of unfairness aspect and I think a lot of that's what we're what we're driving that we all know the situation nursing homes are losing employees. To go work contract labor somewhere else third take on check is bigger of at least experience that my area of and I agree with your intent I want I mean nobody Love home health. Personal care aides more than I do that I don't have the words to describe what what good ones mean to me however I do worry about this bill. And how are we go where or. If if you said if somebody's actually. Contract labor if there actually a contractor independent contractor then they can remain that is that is that what you're saying the all I'm doing is dragging the exemption if they want to continue to pay like that it's not up to me that's why I took the legislative intent out if they want to continue to pay like that that liability whether they're choosing that designation correctly is up to them. Hasn't that always been the case so. What we gave them the eight exemption to allow them essentially to pay through ten ninety nine no matter what we actually gave them carte launch now I'm saying to follow the federal guidelines if you think you're following federal guidelines you don't need to state exemption. And I haven't heard from nursing homes about pay or anything like that what I've heard from his other companies to pay through ten not to be paid their W. two and it is a fairness issue to them because their attorneys tell them absolutely this violates they think it violates federal guidelines and so they paid their W. two and they do have a hard time competing with the companies that pay ten ninety nine because the take home check is higher even though the benefits aren't there and there are taxes on the backend they do have a hard time competing I do agree with that. Mr kind of follow up yes you're recognized thank you. So. With this with the with your amendment in your in this bill are amended form does just does this simply just may. All of the. Any of these agencies would then be like any other business in the state of Arkansas that's correct if they feel they're following the federal guidelines they can continue today was there doing we're just not carving them out at a straight exemption. Okay thank you. Represented Bentley you're recognized. I guess of a good here from the health department for the only represent information it says so I would like to clarify this is not going to be an issue with her at the waiver so yes I had not heard that yet either and I'm she may have told me that last time and I'd forgotten. The represented Payton you're recognized I'm sorry. Records he would introduce yourself and who you're representing Chuck Thompson attorney Arkansas department of health represented the the waiver question would be better served with DHS they administer the waiver for the purposes of Arkansas department of health licensing when we do license of home health this will have no effect on anything that we do our our rules. Okay I require from my question have DHS compare yes you're recognized. Please include your seventy represent. Okay thirty eight on. Thank you good morning dawn Staley DHS. And at we do not have any concerns regarding this bill basically as it is it would work within both the waiver or with those who receive state plan services so we do not have any questions or concerns. Bentley Jerry for the questions. represented Payton you're recognized for a question. Thank you Mr I'm still trying to absorb the amendment at first I was like how can have an effect is just taken out uncodified language but I have opposed your bill on the grounds that I want state law to mirror federal law in regards to how we classify a contract labor and non contract labor. And. Like I said I had five minutes to absorb your amendment. But eliminating the exemption. Does not. Changed if the fact that federal law has qualified him as contract labor do you think the Arkansas law with the exemption has had any. Bearing or influence on the decisions by the R. S. to grant them their contract labor status. That be a question probably better served to them I think I remember back last session it seemed like maybe one of the companies had received the letter but not this is here's a problem I think is like president Bill Clinton at the time that essentially exempted them from some federal department of labor regulations and I think this kind of help to grant that exemption on the state level as well I don't think that that's a question better served for them. Thank you and Mister Vargas have a follow up. Two recognized so like I said I'm I'm trying to process this because I thank getting that it legislative intent out of the way and just looking at the paragraph your eliminating as having been an exemption it may have actually been something that steered us away from the federal guidelines. And now we're just letting the federal guidelines rule that is that how you say exactly how I see it and that's I want thank Representative Gonzales actually called me last night with issued questions and issues about my legislative intent and honestly I just filed the same bill as last year when I went back and read it I thought you know I really don't need that in there if they truly say they're independent contractors and they think they meet the federal definition to go for it and I will take the exemption out so it was actually his suggestion that I take it out so yes I agree with the thank you thank you Mr. Represented Boyd you're recognized. Thank you Mr chair up represented Graham got one question and then if Mister chair will let me one one follow up so. I think I understand what you're trying to do is ensure this group of employees has equal treatment under the law like the rest of Arkansans when it comes to ten ninety nines. Well equal treatment under the law yes when it comes to their employee type so when you say remove the exemption you're saying let's treat them equally that. What one follow up Mr terror yes you're recognized we kind of talked around the iris exemptions or the guidelines and I know you have a finance background could you kind of go over what those are what would an employer would be going through to kind of determine are you at ten ninety nine employee versus a W. two employee thank you yep thank you so I actually a kind of bringing them out before I came because I cannot ever remember all of them and some of the things is behavior control a worker is an employee when the business has the right to direct and control the work performed by the worker even if that rights not exercised M. things such as tops of instructions given such and when and where to work what tools are used degree of instruction evaluation systems training a worker on how to do the job Unreimbursed expenses so they're more likely to incur than other employees we see of the relationship this type of relationship depends upon how the worker business perceive their interaction with one another this includes written contracts This may not be exactly what I had intended to print out here does that with the financial control does the business have a right to direct to control the financial and business aspects of the worker's job and that's when it's talking about considering set different things essentially if that worker is controlled in any way and they're told where to go what to do how to do the job they're trained and there's any financial control over it and then depending on the type of relationship so. In my opinion and I'm not obviously an expert in the tourney anything like that I feel that these people are truly W. two employees but you will hear today in testimony that they feel that they are not and that's okay I took my legislative intent out so if they want to continue paying them like that that that's on the M. and a decision that they can make. Okay any further questions from committee. Representa Miller you're recognized. Thank you Mr reserve grade just real quick to make sure I'm clear we have this exemption in place for several years. And then at the assuming this bill passes. What. As far as to the fairness issue between these different home health companies what changes as far as the fairness between the companies my hope would be that they stop paying through ten ninety nine I don't think that'll be the case I think that they will probably continue to pay their ten ninety nine at that sale they feel that they are classified It just doesn't give them that exemption anymore. So you're right there by a and if I don't pay any differently there may not be a change in fairness right away. Thank you. Okay saying no further questions from committee members. We do have a number of people that have signed up to speak against the bill first on the list is Byrom Hearst. This are you in the audience. Okay if you would come up and introduce yourself and who you represent. is Julie. Hey garc. In the room. Would you would you see if she's in the waiting room you may proceed enrich yourself. Care of others to by our members. Arkansas yes push that button this one yes. Is it on. My name is Q. Byram Hurst and I'm an attorney for superior senior care and course are appreciate the opportunity to be able to talk to you this morning and and I I I've listened attentively in it And rather kind of surprised manner that represented gray is now amended this legislation. But I don't think that that cures all the problems and I'll tell you what I've been hearing in the discourse reminds me of the the old saying if it ain't broke why fix it and because I'm getting the feeling that one what's being said is that passes legislation it won't have any effect on anybody. And I disagree with that and I can tell you that I think this bill is coming at the worst possible time that it could ever come because there is a great need for care givers there is almost of in this pandemic everyone has been encouraged to stay at home almost ordered to stay at home and there's been great concern for in nursing homes and assisted living facilities of getting people together and the super spread out of the of this virus. I don't want to tell you why I really think you should not pass this bill and and and while we're opposed to it. I've been representing super your senior care for over thirty five years and it was about forty years ago that we began to look at this this business endeavor of care givers in people's homes and so I went around the country of looking at a different business models and it clearly there's two business models and I think that's been referred to this morning of the first business model is employee based. And what I learned in regard to employees based as it works like this. You try to hire a care giver as cheaply as you can. And you try to contract with someone who needs care to pay as much as they can and the difference is the profit margin that you will make and that type of business now. The other business model that we looked at was a business model referred to as a care giver giver registry in which you simply keep a registry of care givers and when someone contacts you needing a care giver you send the care giver to them and they contract with the care giver they determine the hours whether it's thirty minutes a day two hours a day twenty four hours a day they determine what the care givers paid and we found that there was much more benefit there may be a lack of profit but there's better care and I want to tell you that it in this business it's very important the relationship between the care giver and someone providing the care because we're dealing with non skilled care we're dealing with people in the most intimate moments of their lives in their homes when they need help in getting to the bathroom they needing help and and really delicate sensitive situations and they want to have confidence in that care giver. And the model that we use which ship sending out the care givers as independent contractors any time that that confidence is breached that person has the right to farm at that moment to change the the method of care giving however they want to do it they're in charge and superior senior care as that type of registry is not in charge and I think it's very important particularly at this time during this pandemic that that we not jeopardize that ability to carry out that type of business I also want to say that. We we've heard about the Internal Revenue Service in the federal regulations concerning independent contractors was superior senior care has been under Internal Revenue Service guidelines department of labor guidelines Arkansas workforce guidelines and past the mall I mean we're conducting business as amended the all of a minute said it's an independent contractor legitimate business and I can remember years ago when Archie Williams was the director of Arkansas workforce and he began to look into this and he and that many many times and he demanded for me evidence of how we conducted business and that he eventually said you're right you've got a legitimate independent contractor business you're doing it properly any provided even as a letter to me saying that she per year senior care was exempt from those taxes. Now this is not an effort to avoid taxes because the taxes are paid the taxes you just paid by the person rendering the care that that gets the income. Now what I'm concerned about where fears regardless of whether the the Legislative intent section is stricken you still have the problem with the bill might eliminate independent contractors and it might be eliminated independent contractors at a time when we really need them it's not if this is the the wrong time to represented writers correct this bill was introduced two years ago and it was defeated and I also recall that two years ago you passed a bill called the empowering independent contractor it was actin fifty five or two thousand nineteen and it defined independent contractors and what it did it was really helpful to the Arkansas workforce and others but what it did is it defined independent contractors the same as the the federal regulations for our rash and it did make it much clearer but I think if you pass this legislation you're still taking a step back from the legislation that empowered independent contractors I believe that that two years ago when this was defeated the the economic climate was it entirely different the Health climb it was entirely different but the problem is it's worse today and it's more important today that you vote this bill down. Appreciated. Representa Gonzalez you're recognized for a question Davis chair believe I'm just totally confused now as to what the issue with eliminating this is with what you just said about empowering independent contractors So anyway my question is. Under the system that we have now and you have these independent contractors but they're hired out by. The singer Sapir care whoever it may be who is a liable for that patient care if something goes wrong it is all the liability on that independent contractor or are you liable for it so that are the contractor that's a good question and and we carry liability insurance that covers the independent contractors as well as the business and that's required and so we we we cover them ourselves even though they're independent contractors. Representa Allen you're recognized. Thank you Mr chairman what you're saying Attorney hers is that this bill would prohibit in the independent contractors from going into the home to do work well what I'm saying is that. I was very concerned with the legislative intent that was attached to it before the amendment I think that that would have been devastating. With this change I believe it opens up a whole new discourse as to whether someone's an independent contractor not because the the employment exemption is taken away. And representa Allen I think the the significance of that may be that it impairs people and diminishes their hope of getting involved in this business. You know for the last year many people have lost their jobs their regular jobs of of being a waiters waitresses protecting the service industry and they've gone into caregiving industry but they don't want to do it full time they may have children at home that they're trying to take care of and they say you know I could work for two hours a day but I can't go to work for this this company as a regular employee but this gives them the ability to get out there in the workplace but but if you take away that employment exemption I think it's going to drive a lot of people away from it it'll even drive some companies right now that it was said this is a small part there's superior senior care but there's also fifty other businesses in Arkansas that operation with independent contractors fifty of them that's thousands of care givers and I I don't think we should be jeopardizing that at this particular time for especially. From a. So are you are you saying that this bill would created a shortage our care give us to possibly create a short well I think there's already a choice what I'm concerned about if you take away that exemption I think that you're going to create an atmosphere where people may of one litigate or administratively determine it whether you're an employee or independent contractor I don't think you you want that going on either in the culture that were in health wise or economically. Thank you Mr thank you represented Payton you're recognized. Thank you Mr. you're talking about a letter you received from RT Williams from the state of Arkansas regarding this when what was the time frame on that. In my memory is not as good it was quite some time back so my point is I'm going to get sued I don't know when Mr Williams I don't recall the dates that he was the director but it's probably been at least twenty years. So wouldn't that predate this exemption that was in code well it should it should and and that's one Listen I was a little surprised when the the do you have legislative intent section was withdrawn and so I. You know about a trying to think exactly what it would do and I didn't have a chance to really compare the the the employment security bill with with this amendment but I think what it's going to do is because us up because when I say us I'm talking about Arkansas with a lot of problems on trying to define who's an independent contractor in news an employee it's just going to create havoc I think if I could have a follow up Mr. Yes you're recognized so I employed some independent contractors auctioneers licensed in and yeah I have a lot of employees it would prefer to be ten ninety nine status instead of you do and I don't qualify. But you know we have to look at the R. S. Code in and other things we don't have an exemption carved out in Arkansas law I understand how the exemption could give you more security. But my question is do you believe that the exemption that existed Arkansas law has influenced the R. S.. To not challenge the ten ninety nine. In their decision making. I thank the exemption creates more clarity in the law and in in allows you to better know what you're doing I think when you remove that exemption. Even with a ruling by Archie Williams we have an IRS ruling is well we have a department of labor ruling as well even with that it may line up businesses like ours to the determine. Independent contractor status again and as you probably know in in your business that's that's not easy when you put small businesses isn't what that that's what we all are small businesses through a task of going to a regulatory agency spending thousands and thousands of hours and thousands and thousands of dollars when that with that shouldn't be the case we should be trying to to in power more businesses small businesses in particular particularly businesses that are in providing care to people. I take one more figuratively Mr well let me put you at the bottom of the list begins and the committee members let me remind you there's five other people won't speak against this bill so let's try to keep our questions or answers precise if we can. The represented board you're recognized. Thank Mr I just wanted to ask and see if you you could give me any insight into so in twenty nineteen you indicated we passed a bill that empowered ten ninety nine healthcare our ten ninety nine employees any insight into why we would have just given this exemption to everybody to all ten ninety nine employees well my understanding of this act in fifty five of the two thousand nineteen the title was empowering independent contractors and what it really did was provide a definition of independent contractors in Arkansas. That was very similar to the Internal Revenue Service definition. The problem when you use independent contractors is all in the past all of these regulatory agencies have at a different definition of the you know was touched on route of the control aspect the pavement aspect but they were all out there with with the different definitions so it was hard for a business person to know who you know we want to make sure we're doing this the right way but the IRS defines it this way. The department of labor this way in Arkansas workforce. But that bill which was entitled empowering independent contractors. Change the definition that the Arkansas workforce had been using and adopted the definition that the IRS has been using so it brought it into line the just thought. You know it it seemed at that time and you know when you talk about legislative intent and that's something in the legal business that we discussed with judges all the time you know the judges always saying well I think the legislative intent of this was to do this the judge may get it all wrong but it I think the the legislative intent of empowering independent contractors also had to do with benefiting independent contractors and allowing them to work providing him with the clarity in the definition to to the businesses and to them that they enter themselves where they knew what they were. Represented Penzo you're recognized. Thank you Mr chair You mentioned earlier about continuity of care kind of you know the same. A person dealing with the the patient on a regular that's a good thing I mean of of work in health care and especially with you know the non skilled I understand that's very important for the people to have that continuity the two year contract labor and. The employees today. Do they work for other companies are they solely work for your company their work for other companies as well they they have the absolute right to contract out with whoever they would like to know most of the people that we refer I have other only in number in other words they've selected care giving as a business as a profession and they're just sent out and if if we send a care giver say to your mother they talk and your mother determines whether or not she wants to hire that particular care giver and we have found that's much better than the employee based when they just send someone to your home and if they decide they want to send somebody else tomorrow mon get somebody else tomorrow and age if we found it disruptive to the Mendes they get dissatisfied going to be easier one of the employee base companies try to maintain the consensus consistency is will they just send out a different employees so do do you all take Medicaid patients yes okay so does the do you. To do your contract labours do they have to refer report feedback based on. Blake. Every fifteen minute intervals I mean do you how often do they keep track for for Medicaid and Medicaid if the. Medicaid has rules and regulations that must be followed they have approved our form of doing business there specifically approved independent contractors but there's some things that we have to do we have to follow their their rules and regulations the same as as an employee based so we are supplying their work we're getting assessments on the care that's needed and we're also providing feedback of what's going on back to Medicaid Medicaid is is a unusual situation because if someone gets Medicaid they have to follow the Medicaid rules the care giver as well as the business independent contractor or employee okay thank you. Represented Ferguson you're recognized. Yes and like I said I've been around long enough to remember when we were in that gray area of different regulatory agencies having different definitions and For my own personal care people in there were a lot of in the state it wasn't just my people day we're gonna have to fight side paying millions of dollars in back taxes and because that's that was the reason for the clarification in the exemption in the definition so I guess my question is if we remove this exemption is that going to put us back in this gray area where contractors aren't sure if they're even. Working legally as independent contractors I think it will that's my that's my big concern here and I know represent Ferguson you start off by saying you had knowledge of this last time was Senator Ingram and and I I think it does take us back into an area where we we don't know what might happen and you're right I mean it it could end up being matter of a look back at back taxes or things of that nature you know that the the independent contractors they get ten ninety nines and so there they are. The only thing is just responsible to pay their own taxes. So I guess what do you think the point of the legislation is the end if it I mean if people who are paying salaries can continue to do that what would be the reason for getting rid of the exception. I don't think there is a good reason to get rid of it I think it's it's I think it's going to cost confusion and have a and because a lot of businesses problems and a lot of care givers problems and I I think this is not the time that we need to have that problem. Thank you. Okay thank you for your comments thank thank you very much Julie Hey good. Would you come forward. And the Justin we don't want to come up together you same company. And if you would introduce yourself to your representing. My name is Justin Hey good I am the owner of all hard senior care. We currently have over five hundred care givers across the state as well as about eight hundred clients. So I'm here today and I appreciate you letting me have the time to speak but. As we have been in business for roughly seven or eight years and we are fully transparent with our care givers and our clients they know they're fully aware that they are under the independent contractor model. Dating. They love the to have that freedom we have a lot of care givers that you know just take care of a family member they don't want to be tied to the employee model as as some of and just take care of you know they work we have many care givers that work fifteen hours a week we have some that work thirty five or forty away the clients as well love that freedom as the gentleman before me said the clients have that power if they are not satisfied with the care giver they have the freedom to call us and we will try to find them a new care giver as well. We have been through numerous tests as well we passed the R. S. worker classification to the department of labor test at the I've been through through this multiple times. And we feel this model the service our clients as well as our care givers so. Right represent Gonzalez you're recognized for a question. thank you Mr. I think we've heard a lot of testimony on this road but what it does and doesn't do and I think we know the intent that it's not to prevent them from hiring contract labor I think I've heard enough on this to make a decision I would like to make a motion to pass the bill except that. Represented Gonzalez I think you want to call ME question okay we'll make a motion for the question may request. All right I have a motion on the floor for me the question. No discussion on that. Yeah NO discussion is allowed on that. So the motion on the floor is for the immediate question for immediate both. All in favor signify by saying aye. All opposed nay. Mostly nine seven. The second hand I don't see one. All right so. The call me question mean that we're going to vote. What would your motion to pass them on the motion do pass as amended. You pass as amended there is discussion on this motion. Represent Payton you got discussion. Thank you Mister chair and we didn't have discussion on the immediate question motion. But there we have people signed up to speak against this bill and we've not. I heard but one person and part of a second. And I'm not comfortable I may not The Amendment was actually get me a lot closer to the voting for to pass but I'm not comfortable voting for do pass when we're not even. Given the opposition. Much of a chance to present their side thank you. A further discussion. The C. nine The motion on the floor is do pass all in favor signify by saying aye. All opposed nay. The nays have it. Motion fails. Representative bills fail. The man you're recognized to present house bill twelve sixty one. Thank you madam chair. A. Hopefully I can go a little quicker on these bills the first bill H. B. twelve sixty one. Of this bill came from the energy department of the voter department of environmental quality I think this is a. A good bill. And I could talk about personal experience but I won't because we do have time to do that but. Let me give you a little bit of the technical part of it and then I'll give you a short summary and I've asked sector key to come to the table to help answer questions so as you can to register self when we get to comments if if she wants to or needs to. section four oh four of the clean water act. Requires permitting of any activities that would cause a discharge of the waters of the United States so it's a federal requirement this includes dredging or filling activities along our rivers rivers. The states under the clean water act are then required to certify that the activity which is currently permitted by the US army corps of engineers will not cause a violation the state's water quality standards so they have to go to the corps of engineers with their suggested activity. Arkansas has a similar requirement rule two point three oh five for short term activity authorization which applies to waters of the state. What is the state are more inclusive then the W. two U. S. this legislation would give the state the legal authority to permit such activities in lieu of the core so the so that's the meat of this bill the Division would still have to enter into them As with EPA region so there's a lot of work involved even after this passes so in summary the way I see this bill it. I mean it has some clean up language in there but what it basically does is it allows Arkansas to approve these activities of dredging and filling along our rivers rather than the requirement to go through the corps of engineers as I said I've had personal experience with that it's a link the whole process to go through the corps of engineers our state agency is totally adequate to be able to do this administer this program in my opinion so that's basically the crux of the bill sector keel if you would introduce yourself and they may have questions for for your if you want to come in. Thank you chairman of three state that my name is Becky Keogh I'm the secretary of the department of energy environment also director division of environmental quality of so this bill we brought forward and is really a way to provide more certainty in regulatory protection but also more certainty in those that are seeking permits or approvals that they can be assured that their investments in Arkansas will be evaluated but also protected the in in in the future by getting these necessary approval so that we currently have four U. S. court districts across Arkansas so anyone that's doing a project that would affect the the entire state might have to seek permits from four different jurisdictions in addition to getting the for a one water quality certification from our department so what we believe this brings a more streamlined process provides a single point of contact for regulated entities including counties of agriculture and other parts of our industry sector so I know that farm bureau has offered support we've also been in contact with some of the cities and counties who currently. Occasionally and have to. Pursue a for a for permit so we do want to bring this forward as a streamlining and efficiency bill for Arkansas Arkansas has been taken delegation of federal programs has always tried to be out front on that the legislature has been supportive of that because it brings regulatory certainty and we believe that being on the forefront of states the taking these delegations we can shape what that delegation looks like and make sure it works for Arkansas in the future so that's my comments. Well let me just add that I did get a few calls from farmers specifically rice farmers up in my area the state and then they they all were fine with this. Represented Wardlaw recognized. Share the my batteries going dead thank you madam chair. The court is very difficult to do as I would agree with that. But in my district nobody likes given EPA or eighty Q. anymore authority than you already have I mean no one so make me feel comfortable and Senate doesn't already over to you guys Miskito and that the next administration rowing two years away how do we ensure that administration is is easy to do as you guys have been. I'll take that as a compliment it but I appreciate the the hard work that you your district does do and we do try to make sure our regular programs are transparent we worked real hard on that we believe that will be lasting beyond this administration we hope that the current program honestly is that you get your permit from the corps but the enforcement come from EPA that won't change me in that in some cases the the enforcement and permitting will now come to Arkansas so there will still be jurisdictional authority working with the course of I don't see a addition of a departure from the working with your constituents by this administration or future impact I think this will allow them to have more direct influence to make sure that the permitting programs do work for the regulated entity but also a for the protection that's intended you know for waters of the U. S. and waters of the state so that at I don't know how to specifically protect the future but I do think that this program will make it easier for you not only to get permits but also to the. Answer questions when there might be objections to get those resolved on a faster time frame. Thank you. Say no further questions of I'm sorry represented but you're recognized. Thank you madam chair I thought maybe Wardlaw is less of a question for me but So if a DQ promulgates rules on on the cell physical come before a also for approval. That's correct this is this statute is to enable the process to begin there's a lot of work is in working with not only to federal agencies but to establishing rules and those rules just like any deed your rules would come before A. L. C. for review so that that also gives the state and and those of you that have those concerns they would actually give the state more control over the rules and I currently have with the federal of departments issuing these permits thank you thank you madam chair. Any further questions Committee okay say no further questions you want to close for your bill yes let me just make one comment I understand what represent Wardlaw saying I always get nervous when I work with the P. A. R. A. D. Q. when I was on the other side of the fence and industry but the corps of engineers is very good but the the red tape is tremendous and is the one experience I had I was dealing with Dallas I mean they didn't know in this was a project on the White River they didn't know you know they didn't come and see the river I think our local people in Arkansas no more about our streams and are closer to those decisions and I think that the that would work much better and again as secretary said this is just the beginning process so I'll close with a bill and I'd like to make a motion to pass. I have a motion to pass any discussion on the motion. If not all in favor say aye. All opposed the bill is passed thank you mention you're recognized to present House Bill live in fifty four. Okay. like to ask the the department held to come up and help answer questions on this bill. There is an amendment. the Bill. In the miss price present at the amendment okay well he's passing that out in the amendment is is fairly lengthy and I may need some help on answering this questions about this amendment but And my I believe on the amendment the primary reason for it is definitions it the changes some definitions or clarify some definitions Of radioactive waste which is involved in this process so if you would induce yourself and make any comments thank you represent Ladyman Charles Thompson Arkansas department of health tourney represent lane is kind enough to run this bill for us the amendments are amendments are result of the second of the well actually the first input from Nuclear Regulatory Commission as well as as there were some code code style changes the bill or did but because this code style changes that change the language that in R. C. requires and their model language for the states so we had to go back in and kind of fix that so that it was compatible with what and what in or see what in our C. likes to say ultimately what this bill is it truly is a clean up this this act governs how Arkansas handles online Ising radiation that would also include nuclear materials hasn't really been touched since nineteen sixty one and any real form so this is cleaning up the language he's me madam we need to do the amendment first. Okay it does have a motion to pass the amendment I have a motion to pass on the amendment all in favor say aye. All opposed okay you're recognized present the bill. Thank you madam chair thank you Representative this the the act itself hasn't really been touched since nineteen sixty one there some terminology issues and their there and in our city has model state legislation that they put out to the states on language they like to see regarding our regulation of radioactive materials so that's what you have before you and so I I have some some of subject matter experts here if we get down into the actual actual some of these definitions like radium twenty two or I got I got it I got a C. minus in physics I'll be honest with the all that's why I'm an attorney so if we do get to that level I like to bring some folks Committee H. up here but I'd be happy to take any questions on the legal aspects of this. Are you finished presenting the belly ready for questions. Well I just wanna say that this is when they brought this bill to me I read is quite lengthy but it's really important when you're talking about radioactive waste which obviously is generated in the X. ray process so it's important bill so when read questions. The represented Payton you're recognized. My first question is towards procedure. Our way of rules about things laying on the calendar a little bit of time so that. Outside forces can have a chance to know what we're doing and come speak for against the bill we have a. Very significant amendment like this to be adopted in committee can we make a motion to adopt the amendment and then do not consider the bill until a later date so that it. So that we have a chance to absorb I'm a without this amendment been engrossed or don't have no idea what we're voting on. You can certainly make a motion to defer it to the next meeting. Well my motion first survey of members own amendments adopted daughters the amendment and we're just listening to the bill and. Okay thank you represented Payton I appreciate the question and I was going to do it on a members only. Get tied up yesterday when they will do that it was already on the agenda so the C. eighteen hours but I understand your comment there but. It was I just couldn't do it any other way this time so. Well a number is I just committee I sort of understand represented pains concern I I would preferred that we. If you do members on engrossed in the bill it certainly makes it easier to read than trying to read the link the amendment if it's engrossed but receive Wardlaw you're recognized. This committee adopted the amendment will not send this bill to engrossed in until the committee takes up the bill so if if we table this for engrossing the member record chairman Ladyman would have to take this amendment to members on for that to be engrossed bill after today so I just wanted are standing committee adopted the amendment does not send it to engrossed and until we take up the bill itself size room members to be clear on that so when you're looking for to be engrossed next week you it the only way to be engrossed as members on. Madam chair I don't mind moving this to next to Thursday's agenda have people have time to look at it. with the amendment already been approved we do have a heavy agenda on Thursday in this first day of scope bills but I'm okay with moving into that day if that's the will of the committee well I I guess my question is is the health department bill just happened to clean up some regulation is that controversial will it is basically it's just matching the NRA the national rules is basically what it is and that's one reason I did this way because I didn't think it would be controversy on. Represent Dotson you're recognized. No I was just going to reiterate what represent Wardlaw said if if you send it to a member's own for tomorrow's calendar it'll be engrossed for Thursday's meeting. Okay any questions on the bill while we're. Represented by. One oh nothing about radioactive material and stuff like that other than you know just rumors and stuff that's why I feel more comfortable with that being engrossed in members of the public being able to sit on a calendar in its entirety so that those problems might be spotted that does any of this have anything any of this radioactive material. Source from fracking or drilling it doesn't affect any of that. In nature. You will take them Representative I may have to ask our physics expert to come up but this doesn't change anything this doesn't expand anything in the current law the strictly gets it up to speed with what an R. C. talks about regarding their current terminology in our seniority for commissions look at this twice and so when they look at when they thank you burnings of here when they look at that when they look at state law because we we are the first line for for Regulation of the stuff when they look at state law there certain things at once and it will make sure it's in compliance with the CFR and and federal law and so when they see old law an old terminology from nineteen sixty one and they want it updated so that's really what this is that they've if they've gone through it we they've looked at it twice but your but to just make sure that I'm not missing anything and we're totally answer your question of Bernie Bible here he's our chief over the radiation section at eighty eight thank you. We do not regulate fracking some of our licensee's use well logging devices in the fracking within the drilling process but we do not regulate fracking. If I can follow up and go ahead with a mayor may not be true I mean I've heard that the bill drills down comes out of the hole sometimes radioactive materials come up that a radioactive but I know I've seen X. ray machines at the trucks have in a camper on the bed of the truck and they're out having something to do with the drilling and fracking process and and well management I just wanna make sure that it yeah that's an important industry in Arkansas that we don't accidentally and cumbersome and someone yes Sir these these Randazzo radiographers that to a radiographic X. ray the gas gas line pipes and the and you know that is just that something that happens all across the state of Arkansas where you have these gas line pipes is that their X. ray and we verify and licensees and Desiree fought radiographers to be sure that they're doing things safe. In this building change that process at all now it the process this is claims that her language okay thank you. Yep I may represent a Payton I mean these are good questions but you know radioactive materials are naturally occurring in a lot of places if you go to the scrapyard they they probably got an X. ray machine that X. rays the truck because it goes through so you don't get radioactive metals in there a lot of uh mining operations there naturally occurring radioactive ET so it has to be kept below a certain level when I read through this none of that changes this basically just gets us in line with the federal law. Any further questions. Okay what's your desire represent Ladyman you want to pass okay I have a motion to pass any discussion on the motion is amended as amended so harsh a day pass as amended all in favor say aye. All opposed the bills passed thank you. Thank you mention. The Committee I do apologize for bringing that link the amendment to the US all right so we've got a full agenda for Thursday and that will be scope bills first go bills to be heard on Thursday so need to get here on time and hopefully we can get through that agenda thank you for your attention today. We are joined.