Public Health, Welfare and Labor Committee- House

Okay if a I want to remind everybody in the audience that there's someone here that wants to speak for or against the bill and you haven't signed up yet please do that. And members you know in the there's pictures on your desk there of the committee so don't forget to take those with you when you leave today and I want to remind everyone again to to let us know if you're ready to run your bill we need to get the agendas filled up here next Thursday scope Bills we'll be able to run scope bills next Thursday so we needed some of the other bills on the agenda and run those before we get into the scope bills so please if you're ready to run the bill let me or feel know and we'll get on the agenda. All right so we'll move on into the agenda of one thing the streaming may or may not be working we're not sure whether it's working so if you get taxes or whatever it it may not be working they're having some issues with the servers but I've been told that they are being recorded so if someone can't get online once the streaming you can tell them that it will be online later on and they can look at the recorded meeting. All right of. Representing Representative Pilkington. cannot be with us this morning he had to take his wife to a doctor's appointment of she's expecting in a few weeks so this was not something that he had planned something that came up so he won't be with us today and I hope everything is fine. So we will move on down Representative Meeks are you here. All right. So represented makes you have bill H. B. eleven eighty eight correct a certain okay you're you're recognized all right thank you Mr chairman college this morning brain you house bill eleven eighty eight it's pretty basic bill how what it does is it allows a technician who can currently coming to your home to install like broadband router or internet did also be able to install a smart doorbell or camera things like that so these are the items that in devices that you could go out to Walmart by yourself and install on current law states that they have to have a high level of license to be able to do that this is simply says that if you can install one of these doorbells if you can solve one of these cameras yourself that these technicians can be allowed to do it it's we've got an amendment that we're gonna do over in the US Senate we've got some a little tweak that's agreed upon between the state police and the entities that are concerned here but otherwise at all it does is it allows someone who can already committee or house to install broadband or routers and stuff that also bill store install somebody smart devices and with that be happy take any questions. Representa Wardlaw you're recognized for a question can you explain to me what the amendment does so one of the concerns is that if you look on here item C. the talks about that a technician who's going to do this is gonna be required to have a a state criminal background checks all we want to do is to try to tighten that language up and the other concern was that we want to make sure that the devices that are included in this our basic devices we don't want to open this up for like someone to install a you know far suppression system this is just the simple devices that you and I can go purchase off the shelf so we wanna try to clarify that by but those will be worked out down on the Senate side but that's been agreed upon by state police and and the entities. Thank you Mr. Resented Payton you're recognized for a question. Thank you Mr chair so I appreciate the bill good idea of as you work on section see there is they're just saying that they obtain a background check should we not say that they pass it how did you not anyone and it can be released right right. That that's a very good catch I agree totally an amendment and hopefully the folks behind me who were gonna work out that amendment will will make sure that corrections in there thank you project that. Okay. All right seeing no further questions we do have one person signed up to speak against the bill. A major Lindsey Williams You would please enter this yourself and who you represent yes Sir my name is Lindsay Williams I'm a major with the state police and I'm responsible for the regulatory division which includes a private investigator security guard last thing Monday other things in I don't wanna I don't want term against to be take into to literally one of the save right off the bat to appreciate the Representative Meeks being sensitive and the the others involved with this in our concerns and he did express those pretty much is I related to him in the background check the we did have a concern that it did not include a federal background check is written a state background check is all this required. That information is very limited in in what comes back on the state background check and saw the federal is is broader in and more appropriate on the is the there is that limiting the scope and definition of the vast is is he mentioned that is is written right now device would include more complicated systems the whether it be security or fire and some of those more complicated systems obviously require more expertise and training in this would be limited to the doorbell tap devices or even cameras on the that outside or even the interior of the home so we just wanna make sure that that was there in the in and then also the what represent Payton mentioned that they they pass a background check the instead of just getting one in we would the background check would come to us to be initiated by the company and then we would review the results and based on criteria for qualification or disqualification we would notify the the company that that person is is suitable for for employment in the installation of these devices in into a fee for the background check would be the responsibility of the of the company or the individual. Represented were logical question to Mr you're recognized. First question is the colonel you're testifying on this bill today yes okay just wanna make sure we had that issue already another committee on the sister bill of this second question is on the federal background checks how long does it take to get one of these back and what's the expense to the employer or the employee for that federal background check the expense I believe is around thirty thirty dollars for the state and federal the time it takes to get one back is very minimal barring The New under definition a minimum I mean is it one that isn't thirty days you know I'm sorry that that is a vague vague term we're talking about the two three days Miller is coming there no background check issues that outstanding offenses or dispositions that need to be obtained thank you Mr. All right seeing no more questions thank survey comments. no more questions from committee so is there anyone in the audience who would like to speak for the bill. Against the bill. Cingrani read close. I think I'll close for the bill thank you committee I appreciate a good vote thank you the Representative Eubanks you're recognized motion to pass. I have a motion do pass any discussion on the motion. Seeing none all in favor signify by saying aye. All opposed nay motion carries congradulations Representative bill is passed. Okay we're gonna move on to S. B. and ninety nine. Representative bought them believe their. The witness to be here with me yes. If you would have you within the center booster self and who she represents. Kristin Stiffler and I represent the national psoriasis foundation and the R. Kansans for step therapy reform Representative you're recognized to present your bill thank you Mr chair thank you Committee I'm excited to bring to you Senate bill ninety nine to your committee today it's been exciting and an honor to be a part of such an altering. A life altering bill for our Kansans. This bill came out of the Senate with notice ending fights and I hope today we can get through your committee and onto the floor to the floor next week because this bill is important to protecting patients from the potential harmful use of insurer practices called fail first. Stepped therapy also known as bill first is a process that requires patience to try and fail one or more medications chosen by their insurer before they can access the treatment prescribed by their healthcare provider these policies can be a burden to patients often causing delays of weeks and even months before getting access to the treatment they need this legislation will not ban the use of stepped therapy but instead your instead require reasonable timelines for exceptions request appeals and to ensure the implementation step therapy requirements will be based on medical and clinical guidelines and not require patients to try and fail on medications they have already taken or that are not in their best medical interests based on their personal medical history or condition. This bill will ensure stepped therapy step therapy protocols are based widely on widely accepted medical and clinical guidelines it will create clear and prompt processes to request a medication. Exception and require response with the patient's health care plan within seventy two hours for a non emergency and twenty four hours for an emergency situation step therapy protocols have real consequences for patients patients can experience worsening symptoms disease progression and may go without therapy altogether. Patients may miss time from family work and other needs because of poor symptom management disease progression or additional medical appointments to discuss treatment options something we can all agree on is that health plans should promote high value affected care but one step therapy protocols aren't in the best interest of the patient or the overall health care system there should be a clear and transparent process for health care providers to request an exception so patients can access the medicines their doctors have prescribed. As we're doing this bill today please remember that there are two others two dozen other states including Texas Oklahoma Louisiana who have already enacted similar legislation to put. Protections in place around the use of stepped therapy and hopefully us together can add the great state of Arkansas to that list. All right would you witness want to add some comments or you just want to questions. I I do have prepared remarks but I'd be happy to answer any questions nine I I I think Representative body cover the bill really well and some things more specifically in regards to how the bill is drafted and it is the first act is that the bill ensures that step therapy protocols are based on widely accepted medical and clinical guidelines and that there's also a clear at and Expedia's process to allow for the provider to receive the response back from the insurance companies so twenty four hours when it's an emergency situation and seventy two hours when at it's it's not an emergency. And then I think also what is important about the bill is that. It lays out a clear exceptions process so there are five five exceptions in which a provider can request an override to the exception protocol and I think that that is and I that it in the bill it lays out that the if the stepped therapy drug that is currently being requested to the stepped therapy protocol is contra indicated or is likely to cause an adverse reaction or physical or mental harm to the patient. So as an example of that would be a the patient is pregnant and the drug that the insurance company is requiring the patient to to try and fail can cause birth defects we would want the patient to be able to override that have that have the ability to make sure that that their baby is protected at and having the most appropriate drug for that patient at that time another at another exception request is if it's if the doctor knows that it's going to be an effective if the drug is going to be an effective for a patient meaning that the patients at it is known through medical research that a certain drug is actually as we see this in the cancers these quite a bit where hi we know that this drug is targeting for a specific gene and therefore you can try other drugs but they're not going to be as effective in treating that cancer patient and so trying those expensive drugs over and over and over again when the doctor knows that this is the appropriate drug for that patient that patient should be able to override and move to the the drug that is most effective for the patient hi if the stepped therapy drug has been tried before and the patient has failed if the patient has already failed on that drug why it should eighty MPs and have to try again in previous years or if the switch insurance companies and that drug is covered both in the prior insurance company and the current insurance company and that doctor knows that that drug is not going to work for that patient because the mechanism of action is not out for whatever reason is not working for that patient that patient should be able to step through that process and and then I finally there's two other exceptions if it's in the best interest of the patient I find in this exception what's really important is that doctors know their patients fast they know that they know the occupation of their patient they they know that if the drug that's being at. Mandated that they must step through it's going to cause drowsiness and they're a truck driver why why would why would that provider by with that doctor when I put that position on that drug they should be able to step through that drug and explain through documentation that this patient is is a truck driver and this drug that you are mandating that they try first is could cause drowsiness therefore they should be able to bypass that step in the stepped therapy protocol and finally if the patient is stable on the medication and I think that this is extremely important when we see patients that move between insurers from from one year to the next or the employer moves to a new insurance company if that patient is already stable on that medication if that drug is covered on their formulary they should be able to continue with that drug hi and be able to document that that patient is stable with that drug. At so those are kind of the basics of the bill and I. Would be happy to answer any additional questions or continue with at more my prepared remarks the mischief for them all right step four okay I just a minute bill answer this but. Thought came to mind how many states did you say this is already being used in our we have almost thirty states that have passed a form of stepped therapy and I would say that we have over over a dozen that have very strong stepped therapy loss is there any data or any way of knowing that you have better outcomes I mean is there anyway to measure the effectiveness of what they've done in other states. Effectiveness in for patients effectiveness for the state overall for patients for patients at what we have seen that when. Patients don't get the right drug at the right time the right medication at the right time that we can see a lack of adherence to the medication I if if that medication is causing you to be extremely nauseous and not being able to work not being able to a sister family or or go to work hi those economic impacts we're seeing out when you. When that is not available that can be a tool to that piece and we can see disease progression when patients are not getting the right drug we can also see if the opportunity for the development of comorbidities so when there are two concurrent diseases at the same time and so when you're not getting the right drug and you're not following the recommendations of your provider we do see that at the it's at disease prison progression can happen however I would note that stepped therapy at this is a common practice and for most patients the step therapy protocols is appropriate what what we find is that in those cases where it is a chronic disease a complex disease providers need the opportunity to be able to by pass that red tape and to see that that they can get the right drug for that patient. Buster person recognized. Thank you Mr chair I appreciate this bill I have really over the last eight years since I've been a legislator had legislator had to work through several of these issues for constituents For instance we have had patients they were deemed deandre Senate Vanderbilt who were state of the art cancer centers and. The what happens the formula very often lags behind new biologic drugs who are the best treatment and also the medical director for the formulator is often not a specialist in cancer or other drugs so you run into problems I guess my question is is there a time frame on the bill because I've been able to resolve most of these issues over the year but it took months some time so is there a time frame for the insurance company to respond yes there is there is a time line. Seventy two hours for non emergency twenty four for emergency hours so for cancer treatment in that situation I would have to respond to seventy two hours is that right okay thank you. Represented Representative cloud you're recognized for a question. Thank you Mr chair thank you Representative Vaught Mr for bringing this bill I love it. And my question piggy backs off a Representative Ferguson as far as the timing the twenty four hour Jack I can see a situation possibly where on a Friday afternoon okay they turn that in so how does that timing work with the weekends or holiday thank you. For the bill four at the time line and I will pull that information office where hi. We know that these requests are already coming in and when they're timely and we know that the insurers are are doing their best to to respond as timely as possible our bill requires that it is it it would be seventy two hours that's regardless of whether it's a holiday or weekend I would say that if it is an emergency situation and you're talking about a patient that potentially could have suicidal ideation you need to act you can't if there isn't there isn't an opportunity in regards to taking a holiday for that and I I think that hospitals insurance companies they they have those products protocols in place to make sure that they're able to respond especially in those situations this puts common sense guardrails on that process to make sure that we don't have patience whipping through the cracks thank you bill go to page seven line eleven twelve thirteen fourteen I think you'll see Maybe where that can kind of answer your question even a little bit better. Yes you're recognized. Yes I read that and it it seems like if the. The provider does the insurer if they do not respond then it's an automatic that. The provider that healthcare professional can go ahead with the treatment they deem appropriate so the honest in is on the insurer they either need to find some way to be available on Saturday and Sunday or from day or whatever it is that right. Why I waited that is correct and and we at it and at least at I'm trying to pull this from recollection I believe at least over a dozen states have the twenty four and seventy two hour. A timeline correct I'm just present not here speak against that thank you. Committee any other questions. Sorry represented Allen recognized okay I got income lame apologized but I think that this is something that. Be in favor of strongly in favor of what if you go to page three line one eight in the case that this is a list of the types of plants that are not included. So applicability in regards to thank you for the question at it applicability at. At the state level we can only regulate at state regulated plans and so this this further clarifies what plans can be regulated so those that are self funded a recipient. We cannot regulate those pants at the state level all right so this is a this bill does regulate those that are on the the small group and the individual market as well as the state employee's plan is this a follow up is is marked by here from DHS. I have a question for you that's okay. Yes come on up March. Please introduce yourself in the represent. Thanks for more closed parking services okay what impact would this have on the budget. The state that nothing because the Medicare Arkansas works plans are excluded. Will have a impact because they're excluded. If the dollars are question correctly we don't believe this bill would have impact on the Medicaid promedica a budget. You don't think so necessary it's there there is some language in there that does carve out the Medicaid program that be clear the Medicaid program does not use step therapies per se there were some concerns that it might have an impact on some of our other ET fed or in total by requirements that we administer but we don't use that there may be nonetheless no so this bill would not have a physical impact on us okay so. No impact at all okay can can you explain Page three. seventeen seventeen through nineteen. So this is just further clarifying that this program would not be applicable to to Medicaid and so that at and just to further expand on that in twenty seventeen the legislature sought to pass legislation that address utilization management tools through prior authorization and step therapy and so this bill is that strengthening and clarifying the stepped therapy language that was previously passed in twenty seventeen and that bill did not apply to Medicaid and so through that with that is what we're trying to strengthen here. Okay that's my understanding as well. What about Arkansas Works Arkansas Works. Say that again I'm sorry what about Arkansas Works. That would still be Medicaid okay. All right is there any reason why it's not include. I am so at what we were looking at a having the bill drafted and introduced we really wanted to address The twenty seventeen legislation that was passed and so you can see that as we a stricken certain portions of the twenty seventeen bill that bill only applied to state regulated plans and that's why we were looking to only address state Rick regulated plans so the. Patients that are on Arkansas Works. Would not have the benefit of this. That is correct. Do you think Representative Allen we have other people in the queue so if you want to be put to bottom. let me know. Represented Perry you're recognized for a question. Thank you Mr chairman. Representant Allen may of asset but mark what would what impact would this have a financial impact on the state health insurance plans. Resum Perry I'm not in position to answer that as far as the state if you referred to the state employee teacher instructor land we don't miss that program and that's just not something I'm I'm I can dress I'm sorry. All right of any further questions Representative Allen did you have for the questions. I'm. Arkansas about that a Arkansas Works. It's a state program I think that those people on that program and that program deserve the same opportunity as anyone else Number of counsel a patient currently and their use in. Drugs on me today that the prolonged life. And I think it does that in this program. should have that same opportunity so if if it works for me if a person patient is there a certain program I feel that patients deserve that same opportunity if any of the patient full of all those can benefit from this I'm S. asking why not that the. Thank you Representative Allen I I I think that's a fair question when looking at how the applicability works for state regulated plans just in general we can also point to the fact that we can't address recipients as well that's addressed at the at the federal level so while though our ability to an address a smaller number of plans and address for a small number of patients I I think that this is moving in the right direction and I think that Those are the I think there's definitely opportunities to continue that discussion but at this bill was specifically set to address the twenty seventeen bill. It was previously passed. Right. Any other questions represented very recognized. All right so I'm I'm piggy backing off of represent of Alan but so the does the Arkansas Works program you stepped therapy. Not to my knowledge now I can't tell you that for certain in terms of the for those who are on the qualified health plans I can tell you that on the fee for service side which include are medically frail population in Arkansas Works as well as those who when they start the program in a transitional period we do not use step therapy okay because I mean that's that's the business I did and I don't I don't ever see it but if if it's the Arkansas Works program is excluded because it's a federal program the end of the market place plans witcher. Federally funded as well through that how would those be. Because those are included. So they do have. I would sit there are their unique requirements that apply the Medicaid side that don't necessarily imply on the marketplace I'm with okay all right thank you. Mr Ferguson you're recognized. I have a question for mark I guess I'm a little confused because Arkansas works is a state regulated planned why would it not be included. I'm sorry in terms of of the in the people they range insurance on Arkansas works it's a state regulated planned or they not included in this bill well it the the language in their index excludes programs that are as I understand that are centrally funded by Medicaid and so that's that's what pulls us out so it's then anything the with it being state regulated insurances because its Medicaid funding okay thank you. Right any other questions from committee. All right seeing none I thank you all for your comments we do have one person signed up to speak for the bill. Laura bargain Miller I hope I didn't butcher your name there. Lara bars in their. Please the interests of again in the mornings of committee and committee chair members my name is Laura bargain there I'm a nurse practitioner I specialize in in mass which is a chronic immune disease that affects men A. R. Kansans It affects you know it's the most common. After a dramatic brain injury that disables young people and so I practice in the center that we manage four thousand MS therapy MS patients and stepped therapy protocols of negatively impacted my patients and my ability to care for them So patients that have been stable on drugs for years at the beginning of January we get. Dozens of letters saying their medicine is no longer covered that we're going to have to change them to another medicine that's going to be you know what is considered therapy for them and so I have two full time coordinators of a pharmacist and a registered nurse and we spend a significant amount of time just filling out authorization forms writing letters of medical necessity conducting peer to peer reviews just in order to appeal the stepped therapy requirements and that time could be more valuable and worthwhile spent on taking care of our patients and their medical needs to prevent just long term problems. All of them have and the rich the bulk of things that are negatively I'm. Result in long term cost to my patients to their families and to society at large in order to care for these disabled patients and so further loss of employment and productivity in our disabled MS patients And just complications from not being on the medicines that they need to be contribute to other the cost of rising health cares often complicate if I was diagnosed with MS if you were if your granddaughter sent would you want them on the best medicine that's going to treat them to prevent them from getting further damage in their brain losing brain volume you know being able to walk you would want them to be on the most optimal treatment that's going to protect them to keep them functioning just like they are today medicines we didn't have any medicine for MS until nineteen ninety three and it's really a vault over the years but we're we've got good medicines that will keep them functioning like they are today one of my first question they usually ask will when I'm not going to be in a wheelchair. As a you know now we've got medicines our goal is to keep you out of a wheelchair but if I have to go through step therapy sometimes and I cannot treat them all to Molly to begin with and they have a relapse brain damage that's your reversible then they may end up in a wheelchair they may you know have chronic costs that are going to affect to them for a lifetime. An open thank you for listening I'm open to any questions. Any questions from committee. C. nine thank you for your comments. is there anyone in the audience who would like to speak against the bill. For the bill. Seeing none are you ready to close represented closed thank you at I hope for a good vote. What will the committee. A by you're recognized thank you Mr chair motion to pass a motion do pass in discussion on the motion. Represent a person recognized obviously and for the bill but I I guess I didn't realize until today that Arkansas Works wouldn't be included on the Medicaid wouldn't and adeno the bill is what it is but I guess maybe we need to run another building create Arkansas Works because we're excluding a huge portion of the population that could benefit because Arkansas Works does she stepped therapy so just food for thought you'd Senator Bledsoe thanks. Any other discussion. The motion is do pass all in favor signify by saying aye. All opposed nay. Motion carries congratulations or thank you Committee thank you Mr chair. Okay we'll move on to HB eleven seventy six by represented Johnson is he here. All right he may have stepped out momentarily we'll we'll pass over that come back to him so Representative Johnson are you ready to present HB eleven eighteen. You're recognized to present your bill thank you Mr chair member. Members of the committee H. B. eleven eighteen. Amends the cottage food production operation and. Very simply what it does it's a very short bill is it makes it to where cottage food industry can sell their goods online on their own website Specifically in state but if they are trying to sell across state lines they have to comply with any federal regulations regarding food safety so it gives in villages sell. In state for sure are from their own website which currently they're they're prohibited from doing. One happy to try to answer any questions. Any questions from committee. Seeing none. Anyone in the audience want to speak against the bill. For the bill. Seeing ninety red clothes reveal the clothes make a motion to pass I have a motion do pass in discussion on the motion. Six seeing none all in favor signify by saying aye. All opposed nay. Motion carries. Graduations representing your bill is passed. represented Johnson are you ready to run H. B. eleven seventy six. Yes Mister chairman apologies for stepping out too much coffee this morning I picked the wrong time to go to the restroom up that's all right you're recognized to present your bill thank you Sir I have an amendment or my bill that I think is being passed out right now I'd like to present that first if it's a. If it's okay with the chair in the committee. Try to give everybody a chance to get that from him before we start. All right written Johnson you're recognized to present your amendment thank you Mr chair committee this amendment does two things if you have the bill in front of you it strikes on page two B. two a this is why I'm sorry no be warned this would be line five on page two. The lease line five. Bakkavor wellness better health wellness check services it takes that out of the bill. A Representative yes I will recognize resented Eubanks yes Mister chairman I move we adopt the amendment. Okay I have a motion to adopt the amendment any discussion on the motion. Seeing none all in favor signify by saying aye. All opposed nay moshing carries your amendment has been adopted and you're recognized to present the bill thank you Mr this bill has been worked on between the barrel providers and DHS for last couple months we've been trying to work out the situation that C. occurred which is in the pandemic we at during the state of emergency DHS has been paying for some telehealth services as they relate to behavioral health and in the process of that is to be in determined to get thank and that the behavior of providers have found this to be beneficial the people receiving the services and found to be beneficial and there was a desire on the behavior health committees part to extend past the pandemic Emergency debility to get reimbursement for the services and so we've been discussing this with DHS this is a bill that's been negotiated in this DHS is neutral on the B. H. the B. H. community supports it essentially just extends those services and allows them to be paid for now just like they're being paid for paid for the future just like they're being paid for now and I'm happy answering questions on that if anybody has any. Representantes you're recognized thank you Mr chair My my questions really actually for your amendment and kind of thought is better bill forty thirty eight so if yeah if you could explain why sure why you're getting that out of two things we spend one is the behavior of the behavioral health wellness checks those are things that that as I understand it that's a service that's that was new for the pandemic specifically it is not a service that we expect to extend past the pandemic these wellness checks were tried to into the dog with the supplemental services checks they're already in the bill it says the the feeling of DHS and B. H. community that that's already covered with supplemental services and so that that's a service we thank is not gonna be needed moving forward as far as the group therapy there were some concerns about trying to do telehealth group therapy and the pediatric population and so this was another negotiated change will if we can monitor that and look at and possibly adding that later if if necessary that would be great but I I commend the bill of sale items that will take a look and keep an eye on it yes I I I tend to agree with what represented Johnson said I think we should look at trying to see if they can be included. Any other questions from the committee. Seeing none. Anyone in the audience to speak against the bill for the bill. Representative review read close yes some question about thank you dear represented Dotson you're recognized. Do pass as amended. I have a motion do pass as amended in discussion on the motion. Seeing none all in favor signify by saying aye. All opposed nay. Motion carries congratulations represent thank you thank you committee presented. Our committee. We are I have had some communication issues with a bill that we wanted to get on the agenda today we did not do that because of the communication. So I want to move without objection. I want to suspend the rules and move H. B. eleven sixteen from the referred agenda to the regular agenda. Now you can look that up on the deferred agenda on your computers if you. The if you want to look at that so we'll give you time to do that. And so without objection I want to suspend the rules I move that we we moved that item to the regular agenda. H. B. eleven sixteen. Mr chairman yes you're recognized I just wanna hold you for second to we see what it is until you move for without that object yes will give you time to do that. So twenty one needs more time when I call it you let me know once you get to. Eleven sixteen H. B. eleven sixteen by Representative Dotson. the title of the bill when you're looking that up an act to establish Simon's. A wall to clarify the requirement for patient or legal guardian consent for end of life medical procedures for minors. We'll give you time to look at that and give me a few minutes to read that. The. Okay committee I'm gonna ask represented Dobson to go down the table and get ready to present the bill if at any point you know we have a issue with someone needing more time will will stop and move it to another day. Represented option you're recognized to present HB eleven sixteen thank you Mr chair and thank you for the opportunity to to present this before you members I bring this to you Simon's Law. Is a law that's how I became first became aware of probably on a little over a year ago when Missouri passed a similar type law and the reason it's called Simon's law is because in twenty ten. A young boy. My name is Simon Went into the hospital and he had a heart defect and his parents Under unbeknownst to them the hospital and inter do not resuscitate order on without their knowledge or consent and so when he started. To to go the parents watched helplessly as they lost their baby boy without any assistance from medical personnel Simon's law since that time I mean that's terms I'm is all based off him several states have passed it in Missouri was the last one to pass this law about a year and a half or so ago and so I became aware of it checked with our state our staff did some research and currently we do not have a law like that on the books this is not in in Reference to anything that's happened in Arkansas that I'm aware of that anybody that time checked with hospitals sociais Haitian with with children's we work together as far as I know there's no opposition to this in fact any time I've I've brought it up to anybody right I've been called about it kind of the first things people says I can't believe this is a law already and. That's that was my similar reaction when when I begin to check into it so I bring before you as you can see this is an earlier bill number is filed at the beginning a session didn't didn't want to rush this one make sure the language old was all right the original draft was based off Missouri's language since then I've worked with various ones to modify the language to make it more specific to Arkansas specifically but I think we've got a a good bill here that will ensure that That sort of situation never happens to any parent or legal guardian or specifically their their child without their knowledge or consent in in Arkansas on the future so Unhappy try to answer any questions. Committee any questions. Represented Ferguson you're recognized. Yeah I was reading one parent is there a provision for the parents disagree. so that was actually part of the the Languages working out specifically with hospitals sociais shin and if. You want to come speak yes please if I want to the hospital association come in kind of speak to that language specifically they were added they added into this might be a little bit more Able to address that specifically Senators yourself and who you represent Sir I'm Jerry entered I'm the executive vice president of the Arkansas hospital association and we do have that happen periodically where two parents disagree thank you but if you have one parent who agrees to consent it's very consistent with the other laws we also in Arkansas have the health care decisions act which helps consent and how long you have to make those decisions and and that kind of thing so instead of saying both parents have to agree both guardians have to agree one has to agree and then if something else happens we point to the healthcare decisions act and follow that policy there after. What you don't want is parents to disagree for such a long amount of time that you have injury or extra harm to the toppled. I guess so would you agree with the do not resuscitate parent or the parent that wants to recess today. So in Arkansas thank you you the default is life so you agree with the parent that needs a little bit more time. Okay thank you. Representing Gonzalez you're recognized for a question. Thank you Mr I agree with most what you're doing here but I can see a situation where. The parents just won't let go there's no chance though no chance of life and they just can't make that decision I won't do it so what what would happen in that situation. The parent must consent. The parent must consent to withhold such so for how long and how how long with the hospital be. Liable for for keeping this personalized for as long as it takes about. A committee any other questions. Thank you for your comments of seeing no further questions are you ready to close for your bill. Yes I'm closing I make a motion to pass. Are we have a motion of do pass any discussion on the motion. Seeing none all in favor signify by saying aye. All opposed nay Motian carries. Representing your bill is passed.