Public Health, Welfare and Labor Committee- House
Video
Transcript
1 document
Bills discussed (5)
| Bill | Title | Sponsor | Status |
|---|---|---|---|
|
HB1212
Act 153
· 3 mentions in transcript, agenda, chapter
Matched: “bill is mine. All right, so I'll present HB 1212. Madam Chair,”
|
TO AMEND THE DIVISION OF WORKFORCE SERVICES LAW; CONCERNING THE NONCHARGE OF EMPLOYER CONTRIBUTIONS FOR … | Ladyman | Notification that HB1212 is now Act 153 |
|
HB1322
Act 132
· 3 mentions in transcript, agenda, chapter
Matched: “to HB 1322, Representative Holcomb, if you'd come to the front there.”
|
TO AMEND THE TIMELINE FOR EMBALMING A DEAD BODY IN THE STATE. | Holcomb | Notification that HB1322 is now Act 132 |
|
SB21
Act 74
· 3 mentions in agenda, chapter, transcript
Matched: “…AMEND THE TIMELINE FOR EMBALMING A DEAD BODY IN THE STATE. SB21 D. Wallace TO EXCLUDE MILL SCALE AND SLAG FROM THE DEFINITI…”
|
TO EXCLUDE MILL SCALE AND SLAG FROM THE DEFINITION OF “SOLID WASTE” IN THE ARKANSAS … | D. Wallace | Notification that SB21 is now Act 74 |
|
HB1061
Act 311
· 2 mentions in chapter, agenda
Matched: “HB1061 J. Mayberry TO CREATE THE NO PATIENT LEFT ALONE ACT; CONCER…”
|
TO CREATE THE NO PATIENT LEFT ALONE ACT; CONCERNING VISITATION RIGHTS OF PATIENTS; AND TO … | J. Mayberry | Notification that HB1061 is now Act 311 |
|
HB1068
Act 767
· 2 mentions in chapter, agenda
Matched: “HB1068 Pilkington TO CLARIFY THE TELEMEDICINE ACT; TO SPECIFY THAT…”
|
TO CLARIFY THE TELEMEDICINE ACT; TO SPECIFY THAT THE HOME OF A PATIENT MAY BE … | Pilkington | Notification that HB1068 is now Act 767 |
Machine transcript
May contain errors. Verify important quotations against the official video.
About transcript accuracy
- Source
- Whisper
- Model
- ggml-large-v3-turbo.bin RTX5060
- Processing date
- October 6, 2026
so now that we got our picture taken and got that out of the way we'll move right into the bills here and get going we need to keep on time here the first bill that's listed here on the agenda there's quite a few people here to speak on that so what i'm going to do is is pass over that and go to the other bills and then we'll come back to that later on. So I guess the first
bill is mine. All right, so I'll present HB 1212. Madam Chair,
Representative Kenneth B. Ferguson
Unverified
0:48
you got the mic there. And you're recognized to present your bill, Representative Blaneyman.
Thank you, Madam Chair. I'd like to ask Dr. Childress with Workforce Services to come up and help me answer questions on this. We have a couple other people here from Workforce Services that we might need assistance from. H-Bill 1212, this is an act to amend the division of Workforce Services Law. And I'm going to read a few of the reasons that we're bringing this bill forward,
and then I'll add a little bit at the end and I'm sure you'll have some questions about this. Why are we running this bill? 2021 UI tax rates are determined based on the employer tax contributions and the UI benefit charges through June the 30th of 2020. So these are the charges that businesses pay when they have people go on unemployment. Under current law, the spike in UI claims between April and June of 2020 would result in an average 36% tax increase for 26,000 employers in Arkansas.
And this would be a significant hindrance to re-employing Arkansans. So, you know, without some action, 23,000 employers in the state of Arkansas would see a 36% tax increase in their unemployment costs. uh the governor's uh executive order 20-54 suspended the provisions of 11-10-703 that would cause the increase uh that would would eliminate that increase
however upon termination of the emergency this is the suspension ends and the increase would become effective. So I don't want to get ahead of myself, but you pay this unemployment later on, almost a year later. So if the emergency ended, even though they were suspended during the emergency, the businesses would still be required to pay that money. I think I'm right on that. Only a change in the
statute can provide this long-term protection solution because this unemployment cost for businesses lags. So we needed a change in the statute so that these businesses would not be hit with this large increase in unemployment cost. So this bill adds a new section, 111070387, that gives the director of the Division of Workforce Services the ability to non-charge UI benefit payments
that are the result of a disaster. So in other words, credit those businesses so that they're not covered, that they don't have to pay that unemployment cost that they really had no say in. It was required because of the emergency. A disaster emergency could be a declaration of emergency by the governor or state or federal disaster declaration. This bill would be effective retroactive to April 4th, 2020, because the second quarter of 2020
is when most of these businesses actually incurred these costs. Even though they don't pay them until the first quarter, they were charged in the second quarter of 2020. And this bill, it would also apply in the future if we had another disaster that caused this same issue. Emergency clause. We need an emergency clause on this bill. Employers must be notified of their
2021 tax rates by March the 1st, 2021. Therefore, this bill must be enacted and effective before March 1st, 2021. And so what that means is their experience in 2020 mandates their rates in 2021. So it's critical that we get this done and get the governor to sign it by March 1st. There's no impact on state GR. The bill would avoid an increase in taxes paid into the UI trust
fund, that lost income, estimated at about $60 million, has been offset by the $165 million CARES Act contribution made to that trust fund last September. So the balance of the trust fund is around $798 million, so this bill will not adversely affect that trust fund. So, I mean, I know it's a lot of stuff, and especially if you're not working in this arena, it's a lot of stuff to take in.
But let me just say, the way this started, Senator Irvin and I had a couple of hairdressers who owned boutiques or hair salons and come before public health in the interim. And one of the women was from Jonesboro. She got a bill for $35,000 for unemployment. She'd never paid unemployment because hairdressers, they basically move. They're kind of semi-contractors. So if they're not making money, they basically move to another place.
So she had never paid unemployment before. She got hit with $35,000. The gentleman that owned that same franchise here in Little Rock got hit with a $130,000 unemployment bill. So they come and told their story, and these were small businesses. And the lady from Jonesboro said, I don't know whether I can continue in business if I have to pay this bill. And so Senator Irvin and I got to looking into this, and come to find out, there were thousands of businesses in Arkansas that had this same problem.
So it was a much bigger problem than we thought. And the number one segment of the economy, I think, was manufacturing that was
hit the hardest on that. I think medical was like, you might have that with you, but we have that showed what
segment of the economy was affected by this issue. And I think manufacturing was number one because there you have large quantities of employees that are laid off.
Representative Fred Allen
Unverified
8:17
Medical was like number four, I believe, something like that, which was kind of a surprise to me. But anyway, it affected a lot of businesses. So we need to pass this bill to make sure that these businesses are active and can get back up and going and rehire their employees. So with that,
I would take any questions. I need to ask my helper here to induce yourself, please.
Speaker 19
8:48
Yes, sir. Thank you, Representative Ladyman. You did an excellent job in describing
Speaker 21
8:54
the bill, and I appreciate you for doing this and for assisting us. Sharice Childers, Director of the Division of Workforce Services. the information that that representative ladyman provided was was right on exactly what this bill does is to place our state in a better position to respond to this event and similar events in
the future and so this gives us a tool to limit that impact to the businesses specifically for quarter two. So quarter two in 2020 is when we experience the largest unemployment increases. And of course, then that is why the rates for employers are significantly more based on the number of people drawing unemployment for that quarter. I have with me today Jim Hudson, who is
with the Department of Commerce, and then also Kristen Rhodes, who can answer those questions and probably has that information as far as which industries were impacted. She probably has that information with her. So Representative Ladyman, for additional questions that may be more deep and which may not be information I have with
Speaker 19
10:17
me today, I ask that we pull them up here when needed.
Okay. Thank you, sir. We do have questions from the committee. Representative Gonzalez, you're
Representative Justin Gonzales
Unverified
10:32
recognized. Thank you, Madam Chair. I support what you're doing here. I think it's a great thing. Something that needs to be done, but my question is why at the discretion of the director? That seems like a lot of power placed there for picking winners and losers if you choose to be, so.
Speaker 29
10:54
Representative, I do not. Page one, line 29. Yeah. Would
Speaker 21
11:01
you like for me to answer that? Yes, you would respond to that. Okay. That's the way that the law is written now for all of the unemployment provisions. These are federal laws through the United States Department of Labor, and we report to the U.S. Department of Labor on all of our activity for unemployment benefits and any of our legislation has to go through the Department of Labor for approval prior to
submitting it for this body to vote on. So that's the way it has been. I don't know possibly Mr. Hudson has that information, but I'm assuming because that's the way that it's already in the the law that way, that it's required for the director to have that discretion. Representative Gonzalez, I
understand your question about concentrating power in one person,
Representative Fred Allen
Unverified
11:56
but I don't know who else other than the director would have more knowledge, more capability to make this or to put this decision forward for other people to look at than the director, and I think that's why it's written that way. I think a lot of these changes would still come before us in council and other committee meetings before a
Speaker 21
12:26
major decision was made like this. Is that correct? Yes, sir. For this particular instance and future instances, the legislature
would have already most likely brought this to the attention of the agency or vice versa. We bring it to the attention of the legislature because it is in an emergency situation.
Representative Fred Allen
Unverified
12:48
And just to be clear, this was initiated by public health chairs. It's not an agency bill. The agency came forth with the solution, but it was initiated by us. Yeah, again, if
Representative Justin Gonzales
Unverified
13:05
appreciate what you're doing. I understand that, but to me, if a company had a big charge on unemployment through that time period, I would think that they would qualify regardless, and you're just allowing the director to pick and choose who qualifies. Am I reading that wrong, or is that how it's?
Speaker 23
13:28
Introduce yourself, please. Yes, ma'am. Jim
Speaker 39
13:35
Hudson with the Department of Commerce. Representative Gonzalez, that discretion really applies with respect to any particular period of time. It doesn't apply with respect to any individual business. So a decision by the director to non-charge would be applicable to all businesses during that time period.
It would have to be applied in a uniform and consistent fashion by law. So the issue is really kind of conferring some discretion on the director to decide with respect to a period of time, do we want to apply a non-charge? And I would say we can represent to you and do represent to you today. With respect to that second quarter of 2020, we will apply the non-charge. There's not going to be any debate about that. That's something we know that we can do. But let's say we get one year or two years down the road, we have another disaster emergency,
but the solvency of the trust fund is at question. We might not be able to do a full abatement. It may be only a partial abatement. So we wouldn't want to have an automatic that it's a non-charge, and now we run into an issue of solvency with the trust fund. So we do want to give the director the discretion to evaluate the need and evaluate what the trust fund is and make that decision. And as Representative Leitman said, we'll be fully transparent on that, and I'm sure we'll be having lots of conversations with you about that decision
because I'm sure you'll be hearing from your business constituencies. Representative
Representative John Payton
Unverified
15:13
Payton, you're recognized. Thank you, Madam Chair. So my concern is the same as Representative Gonzalez, and I fully support this. I think it's necessary. It's almost mandatory that we get this done. But the language in this paragraph, at the discretion of the director,
it doesn't say shall. It says may be non-charged. And then it says to the separate account of each employer. It doesn't say every or all employer. And then it goes on to describe in the base period if the benefits are paid as a direct result of the disaster. So I think it leaves discretion where a certain class of employers were affected by the disaster, and the director would be able to say, well, not every employer is affected by
the disaster, and choose which employers would be made whole or exempted and which ones would not. I'd like to see a change in this language, but I totally support the bill and I don't want to hang it up. But I do believe that the interpretation here would allow the discretion of the director to apply it to employers that the director deemed affected by the emergency and not every employer in the state.
uh representative payton uh i'd be happy to work with the agency and change the language on that if we could and do an amendment on the senate side if that would be i definitely
Speaker 47
16:51
don't want to hold it up i just i really think that you should take concern about maybe modifying this language so well we do we
do need to move it forward but i'd be happy to work with whoever and the agency to reword that to make you, you know, be more comfortable with the bill.
Representative Carlton Wing
Unverified
17:11
Representative Wayne, you're recognized. Thank you, Madam Chair. Just a quick thing, and I'm very much in support of what you're doing. I recognize the absolute need for this, and this is just a small detail, but I wanted to make sure I understood this correctly. This is being retroactive to April, and the monies received, there would be no money that would come back out in terms of a refund from state government. This is money that has yet to be received. Is
Speaker 54
17:39
that correct? That's correct, Representative. This would be applicable to
contributions, taxes that are paid from essentially April 1st on forward. And
Speaker 55
17:45
so it's not money that the state's received yet. So there'll be no refunds coming. Okay. I just wanted to make
sure I understood that. Yeah, it's a reduction in income to the account, not a reduction in the account. Okay. In other words, we wouldn't be cutting checks to
Representative Carlton Wing
Unverified
18:02
send back out. Okay. That's good. Thank you very much. Representative Allen, you're recognized.
Thank you, Madam Chair. I appreciate
Representative Fred Allen
Unverified
18:16
what you're all doing here today, but I do have a question. This is only going to apply during
Speaker 60
18:25
catastrophic times. Is that correct? I didn't understand
Representative Fred Allen
Unverified
18:28
your representative. This bill, this will only apply during catastrophic times.
Through emergencies. Yes. A declared emergency. Yes, sir. Right. Okay. Thank
Representative Kenneth B. Ferguson
Unverified
18:46
you. There we go. Is there anyone in the audience to speak against
the bill? Anyone in the audience speak for the bill? You're recognized closed for your bill representative lady.
Representative Fred Allen
Unverified
19:00
Well I just want to reiterate that this is a very important bill for our businesses. I appreciate the questions that y'all had but it's very important that we pass this move it along and work on it and get it done by that March deadline. So I'm closed for a bill I'd make a motion do pass okay any
Representative Kenneth B. Ferguson
Unverified
19:19
discussion on the motion we have a motion
do pass seeing none all in favor say aye all opposed your bill is passed Okay, we'll move on
to HB 1322, Representative Holcomb, if you'd come to the front there.
Speaker 71
20:08
Representative, you're recognized to present your bill. Well,
Representative Mike Holcomb
Unverified
20:20
thank you, Mr. Chair, committee. Can you hear me okay? Yeah. This is a very simple bill. If you look, if you have the bill in front of you, you can look at line B and line C. Currently, the law says, and I'll read it as is now, a dead body that is not buried within 24 hours after death must be embalmed or refrigerated. And then it goes right on down in the very next line in line B and says, or C, excuse me, and says, when a dead body is being cremated, embalming and refrigeration is not required for a 48-hour period unless a health problem dictates otherwise.
So all I'm asking for in the bill, if you'll look at the line, I'm asking that line B say that a dead body is not buried within 48 hours and to line up with the same as you would do with embalming. Now, several reasons for this. It's almost impossible if someone dies in the winter months unexpectedly in the 8 a.m. hours to get them in the ground in 24 hours. You only got a few hours of daylight that day.
I contacted Laura Shue with the health department, and they said they would look from their medical waste standpoint as funeral establishments are subject to following ADH's rules about medical rules and follow with the department, follow up with funeral divisions, Division Board of Embalmary, and funeral directors. I heard from Ms. Hsu and from the medical waste perspective, embalming doesn't change or impact the rules. Matter of fact, she said that their expert actually reads the rule now as 24 to 48,
but it doesn't say that in the rules so most people think they have to be in the ground in 48 or excuse me in 24 I also contacted Amanda Gibson with the State Board of Embalmers funeral directors cemeteries and barrel services to get the insurance perspective from the board and they tell she's I was advised that they were on the cusp of having some hefty rule changes and I asked about them making this rule change without me bringing it before the committee or before the house she said it'd be a lot easier for us to do it ourselves now i know this is not
for everybody this is going to be for someone like me that don't want to be embalmed it's going to have a graveside funeral uh just be put in a casket and a picture of me when i look fairly good if there's one out there i don't know that there is but uh they're for my family to because i don't want to go through the i don't want to go through the process of you in the body i don't want to go through the church service, then go to the graveside and have several days of grief. Like I said, I checked with the health department.
I checked with the coroners. Most of the coroners that I talked to, I didn't have anyone to say they were against it, so they thought this would help them in their investigation. It doesn't change any other rule as far as the way that a body's shipped publicly now, dealing with diseased bodies or anything like that. All it does is just give us a little more time for a burial. Also give time for a family that's out of town, maybe to get there for a graveside. And actually, a lot of our small funeral homes, rural funeral homes, do not have coolers.
So this will make it easier for them. So that's it in a nutshell. And Mr. Chair and committee, I'll be glad to answer any questions. all right committee
Speaker 75
23:54
are there any questions from the committee seeing none
are you ready to close for your bill representative i'm closed
Representative Mike Holcomb
Unverified
24:03
uh mr chair and i'd appreciate a good vote i'm sorry
is there anyone here in the audience who would want to speak against the bill for the bill all right all right thank you representative what's the will
of the committee? Representative Gray, you're recognized. Motion do pass. Okay, have a motion do pass. Any discussion on the motion? Seeing none,
all in favor signify by saying aye. Aye. All opposed nay. Motion carries. Congratulations, representative. Your bill has passed. Thank
you, committee, for your time. I appreciate it. All right. The next item on the agenda is SB 21. This bill is by Senator Wallace, but
Representative Rye, I believe, is going to present that. So if you would, Representative Rye, come on up
Representative Johnny Rye
Unverified
25:07
to the table. yes sir mr chairman and i'm i need the people here from nucor and they're in the
holding area okay we'll we'll get them
Representative Johnny Rye
Unverified
25:19
in here okay uh do i need to identify mr chairman
no that's all right if you want to go ahead and present your bill or if you
Representative Johnny Rye
Unverified
25:33
want to wait on them that's fine uh you can wait on them it it would be better i can do it but but it's probably better because boy they're these folks are from blival and they really know the whole nine yards
about this situation this first time we've used our bullpen so we're new at this sir it's first time
we've used our waiting room so we're new at this
okay If y'all would, go on up to the table.
Representative Rye is there. And if you would, introduce yourself and who you represent. My name
Speaker 98
26:53
is Kylee Clanton. Push your button there on the... Here you go, thank you. My
name is Kylee Clanton. I'm with Nucor Yamato Steel Company. All right, welcome to our committee. Representative Rye, did you want him to present information on the bill? I
Representative Johnny Rye
Unverified
27:03
can tell you a little, and then I'll turn loose and let him have it, okay? Okay.
Thank you, Representative Ladyman. Y'all, this bill deals with an element called slag. And the biggest steel company in the whole United States is in Blyville, Arkansas. It's called Nucor. And actually, they have been disposing slag for the last 30, how long have we been in business? 32 years. 32 years. Yeah, and actually, it's a byproduct of the steel itself.
And ADEQ has already looked into this situation, and there's no contamination whatsoever. It makes sure that the slag is used for a beneficial product and not a hazardous waste product. and counties in northeast Arkansas and Arkansas Highway Department have continued to use this steel slag for road beds. So it's helpful to the state of Arkansas within the highway department, and then it supports over 100 jobs in northeast Arkansas.
It's a great company, and I think it's a great situation that they have with this slag product. So if you don't mind, just let them know what I
Speaker 99
28:28
didn't let them know, okay? Yes, sir. Thank you, Chairman Ladyman, members of the
Speaker 103
28:33
committee. As I said, I'm Kylie Clanton. I'm the environmental manager at Nucor Yamato Steel in Blyville, Arkansas. And on behalf of our 2,000 Arkansas teammates, we would like to thank Senator Wallace, Representative Rye, and Representative Hodges for SB21, and I appreciate the opportunity to testify before
you today. Nucor Corporation is the largest steel producer in Arkansas and the United States. with more than $22 billion in annual sales and more than 27,000 teammates nationwide. Nucor's presence is a big reason why Mississippi County, Arkansas, is the number one steel-producing county in the United States. We have three facilities in northeast Arkansas, including Nucor Yamato, Nucor Steel Arkansas, and Nucor Castrip Arkansas. In addition, Nucor is also the largest recycler in Arkansas and North America.
Our steel mills recycle scrap from cars, appliances, and other discarded metal products into hundreds of types of new steel products of various shapes and grades. Nuclear Steel Arkansas's products are all made with 98% recycled content. Scrapped steel is not the only material we recycle. Among the hundreds of recycled products made and marketed by our Arkansas teammates are slag and mill scale, which are both the subject of this pending legislation. Steel-making slag has been around and used commercially for more than 150 years.
It is currently used in all industrialized countries where steel is produced. Beginning in the 20th century, many new uses for steel-making slag were developed in a variety of industries, and today's slag has a wide variety of applications. Nucor steel mills produce steel by using an electric arc furnace, which heats and melts scrap metal. Lime is injected as a fluxing agent. This lime combines with silicates, oxides, and ferrites to form steel furnace slag, commonly called steel slag. Slag formation is an important step in the process of producing and maintaining liquid steel chemistry and steel quality.
Slag is then poured from the furnace in a molten state after cooling. After further processing, it is ready for use as a product. Mill scale is produced during the cold rolling process of sheet steel. It is primarily iron oxide and possesses similar beneficial use traits as slag. Nucor Mills in Arkansas produced almost 1 million tons of slag annually, of slag and mill scale annually. In addition to Nucor teammates whose jobs are supported by slag and mill scale production, more than 100 jobs are supported by a local company who further processes and distributes the slag.
These products have been used for over 30 years as aggregate and regional road construction projects, most commonly as a sub-base for roadways. The Federal Highway Administration and multiple state departments of transportation and encourage its use in infrastructure projects because slag has been found to provide excellent adhesion in asphaltic concrete. The shape improves skid resistance in road materials. Slag is highly stable when wet, prevents the formation of ice, does not have problematic surface irregularities, and is easily compacted.
Currently in Arkansas, regulators consider slag a beneficial use byproduct. This legislation would simply codify this classification of slag. In light of beneficial uses of slag and meal scale and its long history as a beneficial use byproduct, we believe this codification is appropriate. It would bring certainty to our business while also removing unnecessary and burdensome administrative requirements that may constrain its marketability. We have not previously requested this amendment to the solid waste definition because of the longstanding treatment of slag and meal scale as beneficial use byproducts by the state.
Their policies for slag use are appropriate, but are also considered guidance. Nucor's experience in other states is that guidance can change, and sometimes without notice. Our request is part of an industry effort to establish the status of slag and mill scale as beneficial products rather than a solid waste. Many state regulatory systems that have substantial experience in the production and use of slag have already recognized the value of steel slag. Other states that have adopted similar legislation include Alabama and Nebraska.
This legislation will bring needed certainty to our business. This simple change will codify 30 years of beneficial use of slag and mill scale here in Arkansas, providing our mills confidence that they can continue operating in the same manner for years to come. Thank you
Speaker 98
32:55
for the opportunity to testify in support of this bill, and I will be happy to answer any
questions that you all may have. Thank you. Thank you for that presentation and I'm
Speaker 107
33:08
sorry I missed your name. Kylee Clanton, K-Y-L-E-E.
Mr. Clanton, so right now the slag is classified as a solid waste and not a special waste, is that correct? It would fall under the
Speaker 103
33:21
solid waste regulations. It is considered a beneficial use byproduct right now. So you're allowed to use
that as a beneficial byproduct by ADEQ even though it would be considered solid waste
Representative Fred Allen
Unverified
33:33
if it was put in a landfill. That's correct. Is that correct?
All right. Thank you. Any questions from the committee? Seeing none. Oops, sorry. Representative Allen, did you have
a question? Okay. All right. We do have one person to speak in favor of
the bill. Bob Smith. You're good? Okay.
All right. Seeing no other questions.
Are you closed for your bill,
Representative Johnny Rye
Unverified
34:22
Representative Rye? Yes, sir. Yes, sir, Mr. Layman. but I'd like to say this too this is one fine company and we have seen four generations of people that were depressed with money finding jobs within Nucor and it has helped Mississippi County tremendously
and I just want to throw that in and I appreciate them so much and the state of Arkansas does too and I appreciate a good vote sir. All right thank you. Representative Allen you're recognized.
Motion do 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. Congratulations Representative your bill
Representative Fred Allen
Unverified
35:14
has passed. Thank you. Thank you for the presentation.
All right, we're going to go ahead and do HB 1068, Representative Pilkington. Representative, you're recognized to
present your bill. Thank you, Chairman Laineyman. I
Representative Aaron Pilkington
Unverified
35:48
have a few different telemedicine bills. This is not my
big telemedicine bill. I know probably a lot of you are getting calls and emails due to some scheduling conflicts that has been moved to a different date. This is my group therapy telemedicine bill, just to clear up any confusion. So if you read the bill, it's pretty short. All it does is include healthcare professionals may use telemedicine to perform group meetings for healthcare services, including group therapy. As we know, during the pandemic, it has been increasingly hard to meet. And one of the biggest issues we've seen is a deterioration in the
mental health of a lot of Arkansans. And so one of the things that I want to do is make sure that we're able to use telemedicine services so that they may have group therapy. And so I've had a friend recently who entered into rehab in another state. And when he was out due to the strict COVID restrictions, they were only able to use group therapy via telemedicine. And so seeing that I wanted to make sure that we can do that here in Arkansas and I've talked to some behavioral health providers who thought this was a good idea so that's why I present to you House Bill 1068
and I just ask for a good vote. Representative Dotson you recognize
Representative Jim Dotson
Unverified
37:02
for a question. Thank you Mr. Chair. Looking through this short bill only question I have really is why don't you have an emergency clause on it? Good question. I don't know. Maybe if this goes through the house without any I can add that on the Senate side, yeah. All right, any other questions from the committee?
Representative Michelle Gray
Unverified
37:24
Representative Gray, you're recognized. Thank you, Mr. Chair. I don't see that this in any way, it's hard to see you over there, this doesn't address insurance or payers in any way. Correct. So do you expect this to just be essentially for cash pay patients or? I just
Representative Aaron Pilkington
Unverified
37:40
want to give them the option, if insurers want to use this, They're more than able to. I just don't want us to have someone to point to
the law saying that because we don't have it in the law, we can't use group therapy through telemedicine.
Okay. All right. Any other questions from the committee? Representative
Representative Kenneth B. Ferguson
Unverified
38:06
Ferguson, you're recognized. Yeah. It's my understanding that there are already, that that's a different part of the existing telemedicine law is about payment and parity. So is that right?
Correct. All right, seeing no further questions, you ready to close for your bill, Representative?
Representative Aaron Pilkington
Unverified
38:27
Sorry, was there a question? Yes, I am close for my bill. Hold
on just a minute. Mark White, did you want to comment? Please come to the table. Introduce
yourself and who you represent. Thank you, Mr. Chairman. Mark White
Representative Justin Boyd
Unverified
38:50
with the Department of Human Services. Here to speak on the bill, I just, I know this has been a topic of discussion among several members,
and so I just want to be very upfront and transparent with everyone. I know we do have some concerns about allowing group therapy, about telemedicine. We've seen some abuse issues in the past with group therapy. There are also some clinical concerns. And those concerns are shared by the inspector general as well. And I believe she's here if any of you have questions. But I'll raise that only to say that there are a number of conversations ongoing right now. We've been talking with Reverend Pilkington. We appreciate his time in those discussions as well as other members. And we're working to come to some agreement on some, I think, some more overarching changes.
And so I just want to put that out there, that there is that discussion. We may get to come at some point to ask for some amendments to this on the Senate side as a result of those discussions. But I just didn't want anyone to be surprised if we seek a change
later based on those discussions. And that's all I wanted to add, Mr. Chairman. Thank you. Is there
Speaker 143
39:52
anyone here? I'm sorry, did you have a question, Representative Boyd? You're recognized. Thank you, Mr. Chair. Just to clarify, I mean, is there something in there that forces Medicaid or the passes or any to cover that that I'm missing or not understanding?
Representative Justin Boyd
Unverified
40:04
I don't know that it does. Our folks are looking at that. And like I say, maybe this is not changed into all those other discussions. I just, because there are those related discussions ongoing, I just don't want to hide the ball from anybody. All right. Thank you for your comments.
Is there anyone in the audience who would like to speak against the bill? For the bill? Seeing none, Representative, do you recognize the close?
I'm closed. Motion do pass. Okay, we have a motion of do pass.
Any discussion on the motion? Seeing none, all in favor signify
by saying aye. Aye. All opposed, nay. Motion carries. Congratulations, Representative. Your bill is passed. All right, so we'll move back up
the agenda to HB 1061. Representative Mayberry, if you'd come to the table.
Okay, are they coming out of the waiting room? Okay. and representative
you had an amendment to this bill as well that we need to i'll
Representative Julie Mayberry
Unverified
41:28
use the microphone i'd like to actually go ahead and adopt the amendment first before we get into discussion if the committee so yes that's what we'll need to
do yeah Committee, we've got a handout that's coming around.
Speaker 156
41:47
Did I miss you? I'm so sorry. There probably will be another, so we'll
get you. Okay, if everyone except the representative at the table would introduce yourself and tell me, tell us who you represent.
Senator Breanne Davis
Unverified
42:12
Hi, I'm Senator Breanne Davis, District 16. Thank you.
Speaker 158
42:18
And I'm Representative Julie Mayberry. I'm just kind of repeating. I'm Jody Entred. I'm
Chair
Unverified
42:24
the Executive Vice President of the Arkansas Hospital Association. Thank
you. Representative, you're recognized to present your amendment. Okay. Members, I wish I
Representative Julie Mayberry
Unverified
42:34
could tell you this is a bill that's been passed in some other state. And we're just using- Hold on. Hold on. Hold on
just a minute. Okay. Do we have the
Speaker 167
42:45
right amendment or is that the wrong- Uh-oh.
Wrong one? Yeah, this is telemedicine. This is not the right amendment. Okay, we got another one coming around. So if y'all will leave these on your table, we'll collect them. That one would have been difficult for
Representative Julie Mayberry
Unverified
43:14
you to get past. Yeah, I don't want to add that to this. It would definitely confuse
Representative Fred Allen
Unverified
43:20
things. All right, so while we're passing that out,
I suppose you could go ahead and
Representative Julie Mayberry
Unverified
43:25
start if you want to. Okay, I just wanted to say that, you know, we're talking about
a very difficult situation that our country is now in. I wish I could tell you some other state has done this, and I can copy their language and see what they've done to bring everybody together, and that just doesn't exist. So I've been working feverishly with as many different groups and organizations as possible, asking for feedback, making corrections and making amendments where I can, thinking of things that I'm not necessarily thinking of. the hospital association very late yesterday we agreed to this amendment and i would like to go
ahead and add it in there um and i don't know if jody ann from the hospital association wants to speak on it a little bit if there's questions if not we'll just kind of wait until all of it comes together whatever the committee would prefer yeah
if you would um tell us why this amendment is required what was the issue with the original bill
and why is this different sure so thank you
Speaker 176
44:24
of course for having me here today forget how tall i am until i'm in this
Chair
Unverified
44:29
committee room um so we worked pretty diligently with representative mayberry and senator davis early on because of course hospitals would love in-person visitation as much as possible within our facilities especially for visitors who are really good at helping us with patient care As you all will remember, early on in the pandemic, we had very little personal protective equipment. We had even less testing supplies. And so it was very, very difficult for us to allow visitors in, especially with the federal restrictions on visitation, CDC guidelines for what constituted infection control policies and procedures,
and lots of other mitigating factors that really kept us doing our very, very best to keep our patients as safe as possible with a lot of things that were unknown at the time. So when we started working with Representative Mayberry, she was very open to us having discussions with her about things in the bill that were very well intended, but still didn't let us progress to allow visitors in a really safe setting. So as you might imagine, hospitals have lots of different rules and
regulations to follow. There's not one particular federal law you can look at to say, this is the one that prohibits visitors or restricts visitors in a healthcare setting. All of those things taken together have to be considered because we are surveyed by the state, both from a state survey perspective and a federal survey perspective. So what we fully recognize and understand, and Representative Mayberry and I have had these conversations, what she is trying to do is only to limit the state's purview. She understands very fully, and don't let me speak for you,
but she understands very fully that the feds can still come in and do what they need to do. So we asked for these provisions that would help the state surveyors know exactly what kinds of restrictions hospitals are allowed to put on visitors in a hospital setting for state survey purposes. If the feds in fact come in and prohibit all visitors as they have for skilled nursing facilities and other entities, we would understand very fully that this law would have a few issues to where we couldn't go as far as we needed to, but she very much assisted hospitals in their
ability to direct the state surveyors on state survey issues to look at visitor restrictions that we put in place. So your new subsection H gives us the ability to create policies that are very clear about when hospitals can restrict visitors in alignment and in compliance with state survey issues, knowing fully well that we'll have federal laws and federal compliance and federal regulations that we will also have to meet. And that's it in a nutshell.
Representative Julie Mayberry
Unverified
47:22
All right. And then I'd also like to add Representative Gray expressed some concern, so we tried to address that in this amendment too. The very last part, it says the section does not affect the rights of a legal guardian or
the holder of a power of attorney. We had discussed that, and I just wanted to let her know that we went ahead and put
that in this amendment. Okay. Representative Payton. Representative Miller, you're recognized for a
Representative Josh Miller
Unverified
47:47
question. Thank you, Mr. Chairman. Obviously, I support this bill. My name's on it. What I'm wondering
about with this amendment, like, it just basically seems like a bunch of common sense stuff that probably, I mean, like you have the hospitals or nursing homes or whatever have the, you know, the ability to remove people if they're being disruptive or mean or shooting spit wads or or whatever. I mean, like, is that not already in code? Why? I'm just curious why this is even necessary, honestly. So
Chair
Unverified
48:24
one of the reasons it's necessary, and Representative Mayberry spoke to
this a little bit earlier, we don't have the luxury of looking at other states to see what they've already done to know what worked or what didn't work and what needed to be mitigated and what didn't. We needed to make it very clear that those common sense things were still allowed. We actually went back and forth about it quite a bit. Obviously, you all do not have a reasonable expectation to be in the operating room when a patient is being operated on, even if it is your loved one and you're a visitor. The previous version of the bill read very, very strictly might have allowed such.
So we asked for that provision H to be very diligent in our restrictions and what hospitals can and can't do to try to cover for those instances where hospitals can create policies already where you have a reasonable expectation for where you can be in one of our facilities so that it just makes it clear that those restrictions are not only okay, but they're actually required. Can I have
Representative Josh Miller
Unverified
49:27
a follow-up? Yes, you're recognized. Thank you. So obviously, our hospitals have had all these policies before, and the fear is that with the bill,
If somebody wanted to be a stickler about the legal language, they could say, you know, without this amendment, I'm saying, if we pass this bill, somebody could make the case they would need to be in the operating room or whatever. So that's, this is a CYA amendment. Okay, thank you.
Representative Fred Allen
Unverified
50:04
Representative Allen, you're recognized. Thank you, Mr. Chair. Question.
Does this meet the CDC guidelines or federal guidelines?
Speaker 176
50:16
So keep in mind, this bill pertains to
Chair
Unverified
50:20
state surveys and state purview. If the federal government requires that state surveyors come in and survey us from the Centers for Medicare and Medicaid Services, CMS, If they require that they come in and refer to particular CDC guidelines for a federal survey, this state statute does not trump that federal survey information.
It only helps state surveyors for state surveys.
Speaker 184
50:47
It does not leak into the federal area for protection. So you're
Representative Fred Allen
Unverified
50:53
saying that the federal guidelines will supersede this? Yes, sir. If that's
the case, why do we
Speaker 184
51:03
need this? It provides direction for state surveys to
Chair
Unverified
51:07
know when hospitals, and keep in mind, I only represent hospitals, can restrict visitors. It basically directs hospitals to have policies for the three types of persons that can be restricted under visitor policies.
Representative Fred Allen
Unverified
51:22
It is very state specific. Follow up. Is there a liability waiver in case a patient, family comes in and contract COVID or develop nosocomial infections? So where will the liability be if proven that it was done in the hospital? we certainly requested
Chair
Unverified
51:50
that but the civil and criminal liability that we requested did not
make it into the amendment however we did not feel like that was worthy enough for us to continue to oppose the intent as you might imagine again our hospitals really are doing everything we can to promote in-person visitation and where we have not been able to do that because we haven't had personal protective equipment or testing supplies to be able to keep people safe or the right personnel who can allow visitors in and screen visitors, et cetera, and so forth. We've done everything we can to effectively allow electronic communication. The impasse that Representative
Mayberry and I had early was the requirement for in-person visitation, which everything in this bill she is trying to do is to promote that in-person visitation in the safest way possible inside of my facility. When we talk about in-person
Representative Fred Allen
Unverified
52:41
visitation, how many people are we talking about? Are we talking about one, two, three, or what? I might let Representative Mayberry speak
Speaker 158
52:50
to that. Well, I think we're getting into more of the bill rather than the amendment.
Representative Julie Mayberry
Unverified
52:57
And so if we can kind of hold that, but what this bill is attempting to do is making sure that there's at least one person allowed in there. I'm not trying to open the floodgates and have parties with tons of people. So to answer your question. So let's the bill specify at least one? Yes. We do need
to stay on the amendment. We'll have to vote on that first representative Allen we can get you back in the queue on the bill I've been
informed that is about the amendment. So go ahead and ask your question
Representative Fred Allen
Unverified
53:29
So does that does the bill specify one person or several people the bill specifies one okay All right representative wardlaw
Representative Jeff Wardlaw
Unverified
53:46
you're recognized Thank you, Mr. Chair. Can I get DHS to the table for a question on the amendment?
Mark Wyeth with DHS. Mr. Chairman, thank you. Mark, I'm assuming you have a a copy of of this i don't have a
Representative Justin Boyd
Unverified
54:17
paper copy i had one of those texted to me but that's what i'm saying um
Representative Jeff Wardlaw
Unverified
54:21
mr chairman can we get him a paper copy please mr
white if you would follow me to the second page where it says page five delete line 18 and
and substitute the following. Yes, sir. If you read that under K, it says a state surveyor agency or a state agency shall not. So it's instructing you that you cannot write a tag if somebody is in violation of CMS guidelines. How long will that last with CMS and what will happen? And I am aware that CMS has their own surveyors and they have sent them to the state in the last year to survey us on this very issue.
So how long will that last, and what will happen, and
what will be the repercussions if CMS finds us in violation of their guidelines?
Representative Justin Boyd
Unverified
55:21
Sure. If we do not follow CMS regulations and guidance in terms of our surveys in nursing homes, and I should back up just to understand that Office of Long-Term Care within DHS is the state survey agency for nursing homes. It is under contract with CMS to do that function on behalf of the federal government. If we do not enforce their guidelines and their guidance, then there are several possible consequences.
CMS could impose financial penalties on us. They also could take that program away from us, and they would conduct the surveys themselves. They already have, in some cases, they send out strike teams, they call them, to do surveys of facilities, and we certainly could see that here. Altogether, if we lost the entire program, that would be an $11.2 million hit to the state. Of course, we'd have to just close that program down. And you'd have federal government individuals doing those surveys rather than state employees.
Representative Jeff Wardlaw
Unverified
56:15
Mr. Chairman, follow up? Yes. So in that program, we have a bed tax. We have enhanced match. We have all those different programs that help us pay for those vulnerable individuals to be in those facilities. Does that in any way put any of that at jeopardy? Or could it put any
Representative Justin Boyd
Unverified
56:36
of that at jeopardy? Potentially so, because to the extent that the state is not complying with Medicaid, the federal government can impose penalties on the amount of federal financial participation we receive.
So they could impose additional monetary penalties on us as well. And I would mention that in relation to this, just to illustrate the importance that the federal government is placing on this, you know, we do enforce these things. We're putting tags on nursing homes when we see violations. We've seen multiple occasions where the feds have come behind us. They've
Representative Jeff Wardlaw
Unverified
57:07
increased those amounts. Mr. Chairman, one more,
please. So I want to make something very clear. Last night, I spent my evening in the hospital parking lot at VA.
My mom's sister is on a vent, and they were talking about taking her off about midnight last night. We were not allowed to go into the hospital. there was some immediate family that was allowed limited down to two this is very important to me this is a bill that actually does a lot in the nursing home industry which is where i'm employed to be full disclosure we have seen a major increase in mortality rates and do i think
some of that's due to depression from not being able to see their loved ones absolutely i believe that but here at the state level we can put so much in jeopardy in that industry in a hole that we will not have that industry to take care of our vulnerable individuals I do not want to see that put in jeopardy so with that I will be a no vote until we
can figure out how to fix the long-term care side of this bill I understand the hospitals are happy and I am tickled pink they are happy but we
need to figure out how to address the long-term care. Mr.
White, thank you. Thank you. Representative
Representative Joe Cloud
Unverified
58:36
Cloud, you're recognized for a question. Thank you, Mr. Chair. Representative Mayberry, on the amendment age part, a hospital office, healthcare professional, long-term care facility, or hospice facility, may established visitation policies that limit or restrict visitation, et cetera.
My question is, it seems like since your amendment would give them the authority to do
this, that would negate the substantiate part of your bill. Can you explain to me how
Representative Julie Mayberry
Unverified
59:12
that would not? I appreciate the questions. My
goal here today is to have this conversation. This is a very serious bill, and as you just said, this does a lot.
It's important that we are taking this seriously. I may not have all the answers. That's what we here as legislators are to
do. And trying to get feedback from as many people as
possible, reading it, I need help. We would be setting a standard for other states to follow. I was concerned about that in speaking with Jodi-Anne. She assured me, and I'll let her kind of give the explanation of that,
because when I read that, I went, does this not just gut my bill? So
I'll let her explain what she told me that made me feel better
Speaker 176
1:00:16
with that terminology. Thank you for the question, Representative
Chair
Unverified
1:00:20
Cloud. It doesn't gut the bill because it establishes that hospitals must have policies. So early on in our negotiations, I actually sent Representative Mayberry the CMS Medicare
Conditions of Participation for Visitor Policies. And in those visitor policies are some of this kind of language that make sure that hospitals may prescribe visitation, kind of rule of the land, if you will, law of the land for these particular types of circumstances. And that's actually to help the public understand who can come in and who can come out. Some hospitals have more resources than others with PPE and other things. So their visitor policies can look a little bit different. As a matter of fact, when I sent Representative Mayberry, the Medicare conditions of participation for visitor
policy, she said, this is fantastic. Actually, CMS promotes visitation, which is very, very true. The issue is CMS promotes visitation, but CMS also has infection control Medicare conditions of participation that come into play here. They are constantly balancing infection control procedures with visitation policies. And on top of that, the multitude of other layers that come in are OSHA, the Office of Health and Safety.
They come in and tell us how we have to protect our employees. So the idea was to give us some language that was flexible enough for us to address the federal guidelines and the state guidelines in a way that keeps visitors safe, but keeps absolutely paramount the issue of patient safety and patient care.
Representative Allen, you recognize. Thank you.
Representative Fred Allen
Unverified
1:02:00
Thank you, Mr. Chairman. I appreciate what you're doing, Representative Mayberry, but you said something that was very important a few minutes ago.
or you said that you needed some help with this because you don't have all the answers to it. So I think that if we pass this bill, not knowing what all the answers are, especially that's related to long-term care facilities, that we may be putting the state of Arkansas in some type of danger. So I want to support your bill, but you got to give me a reason to support it. But right now there are too many clouds hanging out there. for me to vote yes on your bill.
Representative Julie Mayberry
Unverified
1:02:41
And I'm just going to vote, by the way. First of all, we're voting just on the amendment right now, not the bill. I haven't presented the bill. I haven't presented the need for the bill. We're just talking about this amendment and if it needs to be adopted. And that's why I'm trying to focus on that. I haven't really discussed the purpose of the bill. And we have a room full of people who want to come in and tell you their story. And so I would like to have the discussion today. I've told several, even Mr. Chair, that if we need to table the bill, I'm good with that.
I want to feel good about what we're doing. I don't want the state of Arkansas to be in jeopardy in many ways, but I'm trying to, sorry, preserve the health care.
Representative Fred Allen
Unverified
1:03:27
Maybe I should have said your amendment. And I know your heart is in the right place, and you're very passionate about anything that you take on. And for the most part, you're honest, and you've been forthright with all of us. You even sent me a text message asking me if I had any questions about it.
And I would have responded, but I was at the Council of Treatment Centers of America on yesterday, so I did not get the chance to respond to your text message. But again,
Speaker 143
1:04:02
I appreciate what you're trying to do. Representative Boyd, you're recognized. Thank you, Mr. Chair. Representative Mayberry, before I ask this question, I want to disclose to the audience that I co-own two pharmacies, in case anybody, and my wife is an audiologist. Looking at the amendment, it says a hospital, an office of a health care professional.
So if we're discussing the amendment, I just want to clarify, are we talking about dentists? Are we talking about speech pathologists? Are we talking about audiologists? Are we talking about pharmacies? There's a whole litany of health care professionals, and I just want to be clear, and maybe I missed it, maybe there's a definition somewhere that I've overlooked or didn't read, but anyhow, if you could help me with that, I'd appreciate
Representative Julie Mayberry
Unverified
1:04:45
it, thank you. Can I respond to that? So there is in the bill, there's a definition of healthcare professional
on page two, line 25. So
Speaker 218
1:05:10
then, Representative Mayberry, just again, I'm clarifying.
Speaker 143
1:05:15
So then based on that definition, you would consider a pharmacy an office of a health care professional?
Representative Julie Mayberry
Unverified
1:05:22
Do you administer health care? If we need to clean that up, then by all means. But again, that's in the bill, not
Speaker 222
1:05:31
in the amendment. Right, but the amendment relates back to an office of a health care professional. I'm not trying
Speaker 143
1:05:36
to be confusing. I'm just telling you that, let me say this. I love this idea, and I want to see this come to fruition, but I want to make sure we do it the right way and we don't have unintended consequences.
Absolutely. And if we're discussing how to make it better, the amendment, then it might help me as someone who's connected to some allied health
Speaker 222
1:06:01
care professionals that we just make clear one way or the other if we're going about
Representative Julie Mayberry
Unverified
1:06:07
it. So in the bill, clarifying more of health care professional, getting a better definition than what's
Speaker 222
1:06:12
there in the bill. Yes, I'd just like to make sure that dentists would understand that this applies to them and
Speaker 143
1:06:20
they have the appropriate opportunity to voice concerns, what have you.
But again, I will shut up, but I very much appreciate you bringing this forward and having this discussion. Thank you. Representative Dotson, you're recognized.
Representative Jim Dotson
Unverified
1:06:34
Thank you, Mr. Chair. We seem to be discussing a lot of the bill. And so since this is Representative
Mayberry's amendment, I would make a motion that we go ahead and adopt the amendment and then we can discuss the bill in its entirety and hear a presentation. I
Speaker 225
1:06:48
have a motion to adopt the amendment. Any discussion on the motion?
Sorry, Representative Pilkin. Okay. All right. Any discussion on the motion to adopt the
amendment? seeing none all in favor signify by saying aye
all opposed nay motion carries representative your amendment has
Speaker 223
1:07:22
been adopted you're recognized to present your bill thank you
Representative Julie Mayberry
Unverified
1:07:26
um i don't know you can stay okay first of all thank you thank you for the opportunity to begin
discussion. All of you represent so many different factors, different backgrounds, and I know that when we put our minds together we can all come together on something that we can feel good about. We have
been a part of a horrible human experiment on isolation. Yes, the coronavirus
is an awful disease, and yes that has taken the life of many, many people, but I do wonder how many people would be with us today
had they received some of the care that they needed that they were told they couldn't receive, and that's the care of a loved one. Right now, my daughter, right now, my daughter is undergoing her 40-second surgery at Arkansas Children's Hospital. thankfully she's not 21 yet she's only 19 but
if she were 21 she would be at a
different hospital and I wouldn't be able to be there with her luckily my husband is over there sitting in
the lobby only one person allowed in and when I thought about presenting this bill on this day my first reaction was there's no way I can do that I'd be away from Katie and I said well let me go to Katie and ask her. And I said, Katie, how would you feel if while you're having this very long all-day procedure, this is not a minor one, how would you feel if I'm over at the Capitol? And she said, well, Mom, I'll just be asleep. That was her first reaction. And then she said,
no, Mom, I want you to go over there and advocate for people who don't have a loved one with them. And in a few years from now, just two, she'll be at another hospital and I won't be there and my husband won't be there. Since May, in my own household, we have endured 16 surgeries, two surgeries for my husband, brain surgery, not exactly an easy in and out thing, and heart surgery.
For me, I had neck surgery and I had throat surgery. My daughter had 12 surgeries. She spent 80 consecutive days in the hospital, a dozen days off and on in October and November. I've seen the healthcare industry during this pandemic from a patient's point of view, from a spouse point of view, and from a parent's point of view. I've been in ERs, several different ERs.
I've been in different doctor's offices. I've been in different hospitals. I've been in outpatient clinics. I've seen it all over. And you know why? I think God allowed all that to happen so I would have the passion behind this bill. So I would recognize the importance and see what's happening in our healthcare industry during this pandemic. If Arkansas Children's Hospital can allow a caregiver to come into the hospital to take care of someone with no spike in COVID cases, then
why can't the other hospitals, why can't these long-term care facilities use safe procedures to reduce the risk?
yes telling everyone you're not allowed in that is one option that is certainly going to keep things out but is that the best option we have got to return balance to this if all of us were told today that we would never be able to drive again because your chance of being in an auto accident and getting in an auto accident or killing yourself in an auto accident we'd stop that, wouldn't we? We would have no auto accidents because none of us would be able to drive, but
that's not what we do. What I'm hoping to accomplish with this bill is recognize that, yes, there's a horrible disease, but it's not going away, and we need to get back to common sense measures to allow visitors to come in and help, help our health care
professionals do their jobs. I can't tell you how many people I've had text me or call me or write me who are nurses and doctors trying to take care
and they are overwhelmed they want us there according to
CMS 48482.13 the patient's rights section it reads a hospital must protect and promote each patient's rights and it says the standard is intended to provide protection for the patient's emotional health and safety as well as his or her physical safety. Respect, dignity, and comfort would be components of an emotionally safe environment. We are allowing, that's federal
law. That is actually what federal law says. We are allowing guidance to overrule federal law. we need to stand up and say this insanity has got to stop we're allowing one aspect of health care
to overrule the whole thing and we are out of balance and out of whack please help me stand up and if it means we have to make the entire state of Arkansas an example
to the federal government to say we can do better then we need to do that I'll be happy to take
Speaker 43
1:13:36
any questions. Representative Payton, you're recognized. Thank you, Representative Mayberry. I don't know if I can form this as a question or not.
Representative John Payton
Unverified
1:13:43
And I guess my main question is, you're planning on pulling this down and not having a vote today.
Representative Julie Mayberry
Unverified
1:13:49
Is that correct? I would definitely be willing
Representative John Payton
Unverified
1:13:52
to do that. Well, I'm not asking you to do that. I'd love for it to pass. I just
Representative Julie Mayberry
Unverified
1:13:58
need to know whether to be here or not. If this committee says, hey,
let's pass this and work on some amendments on the Senate side, I'm all for that. Let's get it moving along. Let's keep the discussion going. I'm
Speaker 237
1:14:12
open to the committee's decision. Yeah, you're recognized. So
Representative John Payton
Unverified
1:14:17
my follow-up would be my mother was 90 years old and not sick living at my sister's house doing great and because of COVID she spent her last
night on earth alone in a hospital in Little Rock after I begged her to go to the hospital for treatment we didn't know and it had nothing she didn't have COVID we couldn't visit because of COVID and I got in there 10 or 15 minutes after she'd went unconscious but she texted me all night long begging for a drink of water. And I was contacting Jody Ann and many other people trying to demand access and use my position as a state legislator to get in there.
And I got in there. I wish I'd have got there an hour or two earlier or spent the night there. I could have got her a drink of water, but more importantly, we had no idea she was on the brink of dying because she had only been sick for three days. And will this bill allow people like me to get one person in there overnight? That is exactly what I'm hoping it does. Thank you.
Thank you, Mr. Chair. Okay, committee. We may run out of time and we may table this. There's a lot of options
that we have here. But what I'd like to do, we have 12 people here that have signed up to speak for this bill so before we run out of time since they've come to the capitol i want to let them speak and y'all hold your questions till after they speak and we'll get their input on this bill so i want to start out with we'll go down this as you signed up alan floyd is alan here or is he in the waiting room and maybe being in the holding room
Unknown speaker
1:16:13
yeah Somebody open that door if you would, please.
Mr. Floyd? Yeah, if you would, take the table right there. Would you get Mr. Bill Pierce to
come on down here? He's next. He's on deck. Mr. Floyd, you're recognized to speak for the bill. Please introduce
Representative Fred Allen
Unverified
1:17:07
yourself and who you represent. Hello, my name is Alan Floyd. Push the button
Alan Floyd
Unverified
1:17:15
there on your mic. There you go. Hello, my name is Alan Floyd, registered nurse since 2005 and just representing as an Arkansas citizen.
This bill touches me both professionally and personally. To speak personally, my dad underwent open-heart surgery back in April. He spent 10 days all alone with Nona at his bedside. He says those were his 10 days of darkness. And to this day, he will still wake up in the middle of the night suffering from PTSD. A month later, my uncle gets admitted to the hospital as well with a heart attack. His wife is a retired cardiac nurse. Unfortunately, his heart suffered additional heart damage waiting for his heart cath and stent.
12 additional hours that his heart, parts of his heart was allowed to die. I think if his wife was there to help fight for him, he might have a different story. Professionally, I worked at Arkansas Children's Hospital for over a decade, and I can't tell you how many times I had parents come to me and tell me something was wrong with their child. And with them, I was able to help provide positive outcomes. But lastly, I'm going to tell you a story of my wife.
If I wasn't there for her back in 2009, at the med center, as she was suffering with atypical health syndrome, both her and my 30-week pre-term newborn would have died. The medical staff was not listening to my concerns, and it took me personally calling the doctor to save my wife's life. But fortunately, I had the doctor's phone number because she was my wife's roommate in med school. Two hours later, my beautiful son was born. He was born in the operating
room with both general and vascular surgery on standby because they had fear that her liver was hemorrhaging. Later the doctor thanked me for making that phone call. A phone call which saved her life because her husband was not willing to let her die. He was willing to fight for her. More patients have died and suffered because of this pandemic, but not from the pandemic, but from the draconian rules in place keeping advocates away from their bedside.
And it needs to end now. Everybody needs to put themselves in these people's situations to give your loved ones. You guys fight for we the people and we need you. Thank you for your time. God
bless. Thank you Mr. Floyd for your comments. Committee, I'm not gonna take questions because I want to get all 12 people in there to speak. So thank you Mr.
Floyd. Mr. Bill Pierce, if you would come to the table. Would you bring Pat Williams in?
Bill Pierce
Unverified
1:20:12
Thank you all for hearing us. We really appreciate it. Everybody in that room appreciates this greatly, this opportunity. Mr. Pierce, would you just state your name and who you're representing, if it's yourself? That's fine. Yes, sir. My name is Bill Pierce. I'm essentially representing myself. Okay, you may proceed. I've got essentially a letter that I will read here that I sent a lot of the legislators received this email. I'll read this, and then I've got a few bullet points I want to point out as well.
My father was a resident in a nursing home for the past four years where he lived totally comfortably. Family visited frequently, brought him snacks. We got to visit, yada, yada. Unfortunately, for the last 10 months of his life, he was isolated from family and friends, all under the pretense of protecting him. He passed away peacefully the week before Thanksgiving, of course, alone without anyone else there. Ultimately, the mandates and the guidelines, my dad passed away peacefully.
He was 91, he had no other issues, just passed away in his sleep. But ultimately, the mandates in a good portion of the nursing homes have done a big fat zero. It's getting in anyway. It's getting in, it's taken the lives of several residents where my dad resided. So in the end, all it's done is having the elderly die alone without anyone around them. My dad was 91.
He was in full command of his mental faculties. He was an avid reader. He was passionate about science. During one of the last conversations I had with my dad, he expressed his concern to me that he was watching a country die, but not from a virus. His last wish was that he just wished people would quit acting so foolish. And so at that time, I vowed to him that I was going to do everything in my power
to try and help remove some of these, I'm sure they were well-intended, but maybe not very well thought out, mandates and guidelines, and petition like-minded legislators like some of yourselves to help us do that. Ladies and gentlemen, when I have CNAs at these nursing homes come to me, and we get in a discussion about some of the mandates, and I ask them, I say, do all of these guidelines and mandates make sense to you?
And when I have them look at me and say, no, not really, not all the time. I had one of them specifically say to me that she said, I have a feeling if we were away from this facility, we'd agree on a great many things. That's exactly how she phrased it. Now why aren't more of them here testifying? I'm going to be honest with you. Some of them fear retribution. In our country, that should not be the case. And I can't fathom how anyone would be against something like this, against this bill.
The picture here, I apologize, it's small, I was unable to blow it up. That was my dad right there, happy guy. This was taken the week before Thanksgiving. This was literally taken probably days before his death. Kudos to the nursing home. They did a great job. They tried to keep us in touch as much as they could. They sent out Thanksgiving-themed cards with photographs in it right before Thanksgiving. But you can imagine my shock three or four days after he passed and I get this card.
a little surreal. First, let me say that I completely commend anyone that signed onto this bill. Frankly, I find it a little disturbing that we are even having to have this conversation. Our constitution, our common sense, and a little bit of human decency should be all that's necessary. I've heard a little talk in here today about finances, money, and funding, my question to you, is it money over people or is it people over money? And I would encourage
all of you to be real careful how you phrase those things to your constituents because they're listening. Thank
you, guys. That's all I've got. Thank you, Mr. Pierce. Pat Williams, if you would, come to
Speaker 258
1:24:54
the table. And would you get Debbie Billings? I'm Pat Williams. I'm from Harrison, Arkansas, and
Speaker 259
1:25:00
I just want to thank you all for listening and for the opportunity that I came and that you're giving me this opportunity to speak.
My father is 97 years old. He is in an assisted living in Harrison, Arkansas. It's a great facility. um two years ago he was living on his own in his own place he's mine started to decline just a little bit and we decided that an assisted living would probably be good because he would get regular meals his medicine would be given on time there would be activities a lot of social
interaction. They would eat in a centrally located area. They could talk, which is what they need for their minds. So July of 2019, he went into this great facility. March of 2020, they shut everything down. Nothing. They eat in their room now on paper plates and plastic forks and spoons. they shut the activities down they don't have any interaction anymore they can't talk you know to the
other people and he's mentally and physically declining he's depressed you know who wouldn't be one time well the staff we've had several cases of covid the staff are bringing them in They're the ones that are bringing the virus in. So the virus happens in our center, and they're locked down. My father, who has tested positive, he's never been sick.
He has not had this virus. 23 days in his room of isolation, nothing. I mean, who wouldn't go crazy? Who wouldn't mentally decline? I know there's been a lot of talk of money here, but there are people involved here. There are people that the isolation is killing them. It's awful. And my dad, thankfully, is still able to walk around with his walker, and he has a room with a window.
I have come in the snow and the heat sat outside his window talking on the phone to him just so I can see him just about every day I am there and I don't know if any of you all have my dad has hearing aids and I was going in earlier and changing his hearing aid batteries for him so he could hear so now I'm outside the window, talking on the phone, trying to help him change his hearing aid batteries.
This should not be. There are people here. They need us. The isolation is killing them. We need to be able to, I will stand on my head, whatever, to get in to see my father. I mean, I will follow the same guidelines as the staff. I will, you know, I just want to see my dad. He's 97 years old. I don't know how long he has. God is the only one that knows how many days left that he has. But why put him in the situation where he is alone, away from his family, away from everything
that he loves? You know, why? You're killing us. It's not only them. It's the family that can't get in to see them. It hurts. My heart has been ripped out. And you all, it's horrible. It's horrible. Unless you're in that situation, you just have no idea what it's like. So thank you for listening. And there is a quote here that I love from Lou Holtz. He says, don't save my life by preventing me from living. Let my 97-year-old, he says, I'll take the chance with the virus.
Just let me live. So thank you very much for
listening. Thank you, Ms. Williams. Debbie Billings, if you would come to the table. Would you get Janet Caldwell? Ms. Billings, you recognize, introduce yourself and who you're representing. I brought a
Speaker 261
1:29:24
couple pictures just so you all could get an idea of the man that I'm talking about. Because I
Speaker 263
1:29:31
know sometimes, you know, you don't really know.
Speaker 265
1:29:37
you can't really get an idea of the person. But Psalm 22 says, For he, referring to God, has
Speaker 263
1:29:50
not despised nor disdained the afflicted one, but has listened to his cry. So
Speaker 265
1:29:57
we are here today hoping that you will hear our cries. You as our representatives have sworn an oath to uphold the Constitution which protects the rights of all the people.
We who have been afflicted by this isolation from our loved ones are here on their behalf. My husband, Pastor and Missionary Kenneth Charles Billings, I'm sorry, was diagnosed with early-onset dementia at 58 years of age. He retired from the ministry and lived with me for the next six years as he gradually declined.
At the age of 64, when I could no longer care for him and keep him safe, I had to place him in a nursing home, an hour from our home because it had the best accommodation for his needs. This was the saddest day of my life. when i had to turn and leave with ken wondering when would i be back the next four years i drove several times a week to visit him we would go on walks sing songs about the lord
and just sit and hold hands then the virus hit none of us could have imagined we would be isolated from our loved ones for, as of now, almost a whole year. All for their safety, we have been informed. These months have been like a continual dying, as we have been forced to witness the decline and, for some, the deaths of their loved ones
from this cruel isolation. Some have died from COVID. sadly after months of already having been separated from their loved ones not being there to comfort them with their daily needs. So I can only say it is not right nor is it caring to protect people to their deaths. I would just like to say one other thing in regard to a dear friend of mine Gloria Jean Burns and her
husband Bill. She could not be here today because he just passed away in a nursing home and she was not she was not up to coming and speaking to you all. They were married for 62 years and for these last months she could never see the man she had been married to. He died just a few weeks ago in the hospital from COVID after having been protected all those months and away from his dear wife. So I ask you, where is the fairness and the justice in that? So to me, this is not
protection. So I thank you for your attention, and I pray that you will all listen to our cries. Thank you so
much. Thank you, Ms. Billings. Janet
Caldwell, if you would get michael comnett i believe miss caldwell reintroduce yourself and
Speaker 273
1:33:26
who you're representing i'm janet caldwell um i represent
my fellow arkansas members of families with loved ones in nursing homes i also am a member of the Arkansas Caregivers for Compromise because isolation also kills. It's a national group. It was originally formed out of Florida. A lady by the name of Mary Daniels had a husband in memory care, and she took a job as a dishwasher in order to be able to enter the nursing home
to see her husband. She collaborated and got the attention of the governor of Florida, Rick DeSantis and they proposed a bill to allow a family member to come into the nursing home to care for their loved ones and they designated the title as an essential caregiver and it allows one person to come in, a family member to provide care whether personal hygiene
spiritual, reading books and such which allows these family members to come in under that provision, under proper PPE and protocols. We've been working hard at trying to go across the states and successfully do this. However, there's only a few states right now that's recognized that. So it's been 300, my mother's in a nursing home. And it's been 336 days since I've been able to hug my mother, to hold her hand, to
look her directly in her eyes and tell her how much I love her and how much she means to me. We were, the original lockdown occurred for, we were told for the safety of our loved ones so that we could not expose them to COVID. And it's been 336 days and we, the family members, have not exposed our loved ones to COVID. It's been by staff members and outside vendors and such
that this has occurred to. My mother's been in isolation prior to COVID because she contracted a contagious urinary tract infection that's contagious and it will always be contagious which prevents me from bringing her home and but when my mother entered the nursing home activities were great she loved it they kept them busy all day long she was the bingo queen and when lockdown occurred all these activities stopped we had school-aged kids coming to see
them every day. We had clergy coming to see them every day. We had Elvis impersonators coming to see them every day. I mean, there was something constantly going on to keep these people active. And now they're basically isolated in their rooms. Yes, COVID has killed many of the elderly, but the toll that the oscillation is taken on them has killed far more than COVID ever
could. We have dementia patients and Alzheimer's patients that can't understand why their loved ones are not coming around. They're giving up hope. They think that they've been abandoned. I know for a fact that several family members would come every day just to feed their loved ones because that they were the only ones that they recognized and could get them to eat even though the staff diligently tried to and they basically died from malnourishment. It's not on
behalf of the nursing home it's because they just gave up. I see my mother through a dirty window with a dirty screen. We talk on cell phones back and forth to each other. Sometimes we have spotty reception on our cell phones. And that's how I see my mother. I see her through a window. Right now our counts are up and it's three or more visitation stops. We had
outside visitation in a booth. I call it a duck blind. And that's how we would get to visit for 30 minutes one time a week. But when the COVID cases started going up, even though they've been vaccinated, the cases are still going back up again in the nursing home. So therefore, even the outdoor visits have stopped, and we, you know, the people that have died, how do you grieve?
How do you properly grieve someone in your loved one that has passed away in this situation? There's no way to grasp that, how to grieve, you know, all these could've, would've, should'ves, And the guilt that the family members have to live with, not by their choosing, but just how they feel that they've been completely isolated. You call the nursing home one day, and mom and dad's great.
Everything's fine. And then the next day, I hear from my members that they get a call like, you've got to come quick. Some mom's not doing good. And they don't make it there in time. You know, they're only allowed for what they call end-of-life visits, and it should not be that way. It should, you know, I'm all for, you know, one essential caregiver being designated to one family member to be designated to come in to do these visitations
and to leave some of the responsibilities on the staff and to help with their care, something that we've been doing every day. until March the 12th. So I appreciate you hearing me and letting me speak on the behalf of everyone with their loved ones in nursing homes and hospitals that it's imperative that we support this bill
and do set the path for other states to follow Follow and accept these guidelines and
Speaker 274
1:40:24
let us in. It's time. Thank you very much. Thank you,
Speaker 242
1:40:29
Ms. Caldwell. Michael Komet. Komet, like
that. Komet, okay. Mr. Komet, if you would come forward. Raquinta Garrett, I believe.
Mr. Komet, please introduce yourself and who you're representing. And we have a bunch of people that would like to
Michael Comet
Unverified
1:40:55
speak. My name is Michael Comet. I'll be representing myself. I'm nobody. I'm just a guy. I'm a veteran. I served in Iraq like many others. Came home. I have family members, many. I came prepared with five stories just in my little family. But I'm not going to tell any of them. Don't need to. This is garbage. People need to be with their families, especially ones that are dying. If they're dying, what's COVID got to do with it?
I had a family member who was dying of cancer. They knew he was dying years ago. He died, not of COVID, but he died alone. People came from all over the country to see him, his family members, pay him last respects. Didn't even get seen, some of them. And others, they were given 30 minutes. How do you tell your father or your grandfather behind 30 minutes? There's a lifetime to talk about. There's a lot of care not given. I'm not getting the care that I need because of this. My doctor told me over the phone, and I have a phone recording,
I may have lung cancer. And then he told me, I can't do anything until after COVID. How is that acceptable? I understand that's federal. I get it. But a lot of this is over state, too. A lot of it is the same. We got to do better. There's no excuse for somebody dying alone. Anyway, anywhere, everybody gets that chance. Everybody should have that chance. and then we can move on with everything else. Appreciate your
time. Thank you, Mr. Comet. Appreciate your comments.
Speaker 278
1:42:45
All right. Sorry. Mother to Faith, who happens to have a developmental delay and resides in an intermediate care facility in Arkansas. I chose to put her in a facility to get her the help that I couldn't do alone. If I do just go pull her out like I want to, she would lose the help that she needs before covid faith came home regularly pretty much
every weekend and during the summer when she wasn't in school and i was an essential caregiver i'm also her legal guardian and i can't visit my daughter i can't hug my 15 year old daughter children who are developmentally delayed feel the same emotions as you and i happy, sad, confused, angry, worried. However, unlike us, they often have difficulty expressing their emotions. Please put yourself in the place of a person with an intellectual disability.
They do not understand the reasoning behind the terms quarantine, social distance, or coronavirus. All they know is that the person who has always been there for them now has a visit behind plexiglass once a week. Because they are unable to express these emotions in a verbal manner, they may act out to whomever is close at the time. This is the case with Faith, since we have not been able to get regular visits with human touch. The facilities had to additionally medicate her. She also cries for me. Kids that are neurotypical can take walks, go on bus rides, visit their
families even go to camp. Not these kids. I feel these children are being discriminated against just because they have a disability that is not medically fragile. We are all aware of the dangers of COVID-19. However, I plead with you to understand the additional danger of isolation and quarantine. Educational and emotional progress can be lost. So can self-worth and self-esteem. The current COVID situation does not have to make residential visitation and advocacy a yes or a no choice.
Please use your creativity and humanity to devise a plan in which all our children can be safe and also have the opportunity and the human rights of all American children. On behalf of my daughter Faith and all the other children living in residential settings. And intermediate care facilities are grouped with nursing homes. Intermediate is not medically fragile. When the PASS took over, they changed the Office of Long-Term Care to Agency of Aging Adults.
So these kids are in the cracks. There's not really an agency that oversees them. kids have been said that they they aren't getting it as bad as adults we need to do something about these kids and me as a mom to be able to see my child and to hug her and bring her home and to be there for her so thank you for your opportunity to share my thoughts
for your comments. Amy Sorensen, if you would come to the table. Todd Price. Ms. Sorensen, if you would introduce
Speaker 279
1:46:25
yourself and who you're representing. Okay. Amy Sorensen, and I'm representing my mother. I'm her power of attorney. She is in a rehab facility here in Little Rock. and I can echo everything everybody has already said this morning about my experience with visiting
with her. She is in the rehab facility and I don't know if you all know this but since it's a
Speaker 280
1:46:50
rehab facility they have to take in active COVID cases. While I was in the holding room I received another automated call that they have another active COVID case. So the case is when I questioned the staff member about all these calls that we're receiving because every time you get a call it's a two-week delay in coming to see your family member. So when I questioned them is this is your staff coming in
the employees working there they said no most of them is we are a rehab facility we have to take these patients. So my mother along with several other residents is in a facility active COVID cases she doesn't she's not had a positive covid case but she is sequestered because of that and i can't get in there to care for her so the again i won't repeat what many others have described
already this morning but if i could get in there with an ipad and have a zoom conversation with family and friends. The facility won't let us do that because of security requirements. They only allow FaceTime. Not everybody has an iPhone. So family and friends can't visit with them. So that would allow me to get in there and have some sort of something for her to visit with family and friends. I can't even go to the courtyard. They have a courtyard outside on a
pretty day. Sit distance apart, masks on, use all protocol that they would require. And I can't sit there. And she loves music. She loves NPR. She loves political events to talk about. And I can't even can't do that. She recently had a fall and went to the emergency room at UAMS. And I raced over there because I knew they they would let me in. That was the first time I was able to be with
her. She has dementia so it's quite difficult to sit in a at a glass door or window with a phone call. She often will accidentally hang up and you have to help her try to remember how to accept a phone call when I try to call back. So it's very difficult. So I can't get in there. When I was at UAMS, I know the facility where she is, is doing a lot of hard work, a lot of good
work. But I can tell, you know, she needs her teeth brushed properly. She needs self-care done. She needs interaction with myself and with family members. But I want to reiterate what Ms. Mayberry did say at the beginning, that you have very willing participants to follow all PPE protocol, all requirements of these facilities to keep it safe and healthy,
that maybe Arkansas could be a leader, could be a leader in this, and we could show that we could do it safe and
healthy. Thank you. Thank you, Ms. Ornison, for your comments.
Todd Price. Renee Mallory would be next. My
Speaker 282
1:50:24
name is Todd Price. I'm from Cabot, Arkansas. I'm here representing my mother, Donna King, who passed away on October 14th, not of COVID.
We woke up one morning. I took care of her for 13 years in my home. She had an internal bleed, and we went to the cab at ER. They sent us to White County. They could not take care of her. They sent us on to Baptist Medical in Jonesboro. They could not take care of her. We needed to be here in a facility in Little Rock where she had been receiving treatment for 20 years. They finally got her in at 2 a.m. in the morning, but we could not enter with her. She was confused, scared. She was there for many days.
She was ripping out her IVs, sores all over her arms, her central lines in her neck and in her legs. Finally, they couldn't even put IVs in for her to receive the medicine that she needed for treatment. Finally, a hospital staff made an error, and whenever I called, she is screaming. And when I talked to the administrator, we got in finally. When my dad walked in, she was in a soiled bed, soaking wet.
The hospital staff cannot take care of our loved ones. They're overworked. They're short-staffed. COVID has put a strain on all hospitals. But our loved ones are the ones that are suffering. My mom didn't make it. And when we entered hospice, they said her body was in the worst condition they'd ever seen coming from a major hospital in Little Rock. When my dad arrived, he was with her for five days. She never once pulled out another IV. He took her to the bathroom. He got her a simple drink of water that she didn't receive in the days prior to that.
Our hospitals need our help. We need at least one person, and I thank you, Representative Mayberry, for bringing this bill. One family member can make a difference to hospital staff. We need your support on this bill. They say the hearing is the last thing to go. She did get to hear my dad's voice. But will your loved one or friend die in silence? It's up to you. Thank you. Thank you, Mr. Price. Renee Mallory.
Naveen Patel, if you would get... Please introduce yourself and who
Renee Mallory
Unverified
1:52:54
you're representing. Thank you, Chairman Ladyman and members of the committee. My name is Renee Mallory. I'm Deputy Director at the Health Department. And I just want to acknowledge the testimony that we just heard. It's heartbreaking. And, you know, some of us have been through that. We understand that. But we also feel that we would be remiss if we didn't say that there are concerns that we have with the bill. I think Ms. Tritt alluded to the, you know, one of the concerns we have from a regulatory standpoint.
We are the other part of DHS for all the other health care facilities in the state, with the exception of the congregate facilities under long-term care. We do all the others. We do the hospital regulatory. We do home health, hospice, and those kind of things. And so we are also the arm of the feds when it comes to the conditions of participation for those type of facilities. We work very hard so that there's not a conflict with our state regulations versus the federal regulations.
So we just want to say that, you know, we do understand that if there's a, and want everybody to understand, if there's a federal requirement, then that federal requirement will trump the state. if it's more stringent. So with that, I'll also let Dr. Patil speak to the science part of it. And I know that, you know, he's also been in the nursing homes. He's heard these stories. He's held the hands of these people. But still, we, you know, we have the science piece that we have
Naveen Patel
Unverified
1:54:32
take into consideration thank you good afternoon ladies and gentlemen my name is Naveen Patel I'm the medical director for infectious diseases healthcare associated infections and infection control at the Arkansas Department of Health I thank you all for the opportunity to give us a chance to talk here and I echo miss Mallory's sentiment about all the previous testimonials that were given by by patients um i've had a long relationship with long-term care facilities
since the ebola outbreak we have visited you know i think among the largest number of visitations ever in the country for any program we have visited almost all the hospitals in the state and almost 100 long-term care facilities i have met these residents i have met the staff i met the families during these visits after covid hit we have continued to do those visitations to the worst affected facilities and also where facilities were having outbreak and needed infection control guidance my team and my staff have visited more than 150 to 200 such facilities
long-term care facilities nursing homes assisted living facilities prisons jails so on and so forth. So I do understand the the the pain you know the humanity and all those issues that are involved but at the same time to talk from an infection control standpoint how much we know about the virus and how much we do not know yet of the virus. I have seen two facilities where you know you could you could have death and devastation of unknown proportions compared
to another facility. The virus, how it spreads, you know, what toll it would take on these residents is unimaginable and sometimes unpredictable on how this spreads within a facility. You might have exact two scenarios, but in one facility would be really badly affected, one would not. So I would like to go over some statistics and numbers so that all of you are aware. So our nursing home industry has been really hit hard because of the fragility Dr. Patel, would you move
a little bit closer to the mic?
Naveen Patel
Unverified
1:56:49
We're having trouble hearing you. I'm sorry. The nursing home population has been worst affected because of the fragility of the population out there. When we implemented the lockdown in March, there were no visitations earlier on until about June. So the number of cases within the facility, both in staff and residents, were much less, and also the deaths were much less maybe in the hundreds since then and again there are several
contributing factors visitation restriction of visitation was one of them community spread was not that rampant also for the nursing homes to be affected then we did a baseline testing of all the nursing homes all the long-term care facilities in the state we tested about 50,000 staff and residents and we had 0.5 percent of the population that were positive then we gradually opened up Since then, we have never shut down visitation in nursing homes unless there are more than three cases, and the majority of the facilities do not fall under that category.
So, if you see the number of people in the nursing home industry, both staff and the residents, there are about 45,000, 50,000 people in them, of which almost 20,000 people have been infected. That is basically 40 percent of that population. In the state as a whole, out of almost 5,000 deaths, we have 2,000 deaths in the nursing homes, which is 40 percent of the deaths. So the proportion of people being affected in this population is very high. Although they constitute four to five percent of the population, 40 percent
of deaths are in this population. So I would like to request the committee to consider that aspect because with with ongoing you know infections in the state and also the mutations and so on and so forth that coming there are a lot of unknowns that we have we need to be very cognizant of these facts before we start considering open opening up these facilities in an unrestricted way as I have stated visitations are present right now in in most facilities unless they have a major
ongoing outbreak which is more than we consider more than three three
cases all right thank you dr patel thank you all for your comments
Speaker 37
1:59:19
we've got a couple more people that want to
speak um okay mark white did you have any other comments okay um julie bullock
Speaker 106
1:59:34
Okay. Doug Dressel. Okay, he's here already. Okay. Ms.
Bullock, you're recognized. Please introduce yourself and who you represent. I'm Julia Bullock
Speaker 292
1:59:52
and I'm representing myself and good morning. Nursing has its origin and its innermost part of the home. It, in the domestic and everyday life, it's where care is built through nurturing and
raising and protecting and preserving those that we love. On April the 10th, 2020, one of the hardest and most helpless days of my life, I stood outside at the rotating door at Baptist Medical Center as I watched my mom walk in for a double mastectomy after discovering her cancer had returned at stage three. went in alone with no one to walk her beyond the threshold or holding her as she woke up after four hours of surgery. We were forced to wait outside in the parking lot and wait for a doctor to call
us for updates and this was only the first of many phases. She just had surgery number five last Friday and she's got two more to go. A patient's family member can be a valuable source of health information. It can collaborate in planning treatment strategies during the hospital visit. Family members can also help with patient care, removing burdens from the hospital workers. Instead of patient care, the nurses are forced to screen phone calls for family members, helping the patients with restrooms, showering, and other hygiene stuff that they need. That could easily
be performed by the family members. By removing the family from the equation, we are adding that extra care to the care team that is taking care of the patient techs as well as the nurses And they've already got a hectic day of activities that they're already taken care of. And we all know that they're spread thin. On November the 19th of this year, or last year, I'm sorry, I went to St. Vincent's Hospital and I had eight inches of my intestine removed. And I was a patient for six days in there.
Luckily, St. Vincent's allowed one visitor per day for a certain amount of hours. And in that time, my mom, who had just had surgery, was coming up there daily and was helping me get a shower. and get taken care of. There was a couple of days that I went several hours without medication and my mom would advocate for me because I was just too tired to advocate for myself. I've seen this issue from both sides. Being a loved one and a patient in this pandemic, there are so many unknown circumstances. Standing outside the hospital praying and waiting and wondering if
the last time that you saw your loved one is when you left them at the door. Please consider this bill for approval this was my mom as we left her at the door at baptist and thank you guys for all listening to this i know it's a very tough decision for everybody and thank you miss mayberry thank you miss bullock for your comments
uh doug dressel i don't know whether i pronounced that right i can't read it here
but drizzle i should know that doug yeah you should please introduce
Speaker 297
2:02:46
yourself and who you're representing. First of all I'd like to thank each of you for taking the opportunity, let me take this opportunity to address you. My mother's name is Beverly Drizzle. Now I know this is where I would normally tell you my name but this entire trip here to speak to you is on her behalf. Just about her plight along with thousands of other long-term care patients enduring the rules and regulations the state has set forth governing COVID-19 guidelines. I am Doug Driesel, by the way, and I am proud to stand as a voice for my mother, just as she has done
many times in the past for me. You see, my mother suffers from Alzheimer's disease. The loss of one's memory is hard enough, but the loss of that ability to reason, combined with the torture of the last 11 months, and I do call it torture, over long-term care restrictions are all the more reasons to come here today. Imagine, if you will, 11 months, restrictive visitation, room restrictions, absolutely no physical contact from any loved ones, such as hugs, kisses, or holding hands.
Kind of sounds like something that you would see in a visitation at the Cummings Unit, or similar prison facilities around our state, right? But because of fear, our elderly population in long term, right here in Arkansas, are now being treated the same way as our prison population in many ways. This is not to say that her facility, Eagle Crest Nursing Rehab, has not done all they can within the current rules to make her stay as easy as possible. They have. However, in my opinion, one shared by my family, Beverly Driesle, as well as others, are forced to suffer many hours alone
with only minimal visiting times, six feet apart, under the guise of keeping them safe. safe every long-term care facility hospitals and the like have had flu outbreaks which are very deadly among the elderly population but they're dealt with in far more humane ways than taking away their every single opportunity for loving touch from their families in the current situation i can almost guarantee most of the elderly are dying of an even more evil killer that killer
is loneliness. The loss of the last bit of humanity these folks have left in life. Taken away by a disease that is 99.83% survival rate and a panic created by the media that is far and above and beyond the actual need. It will soon be one year. One year of isolation, one year of internment. No going out in the gardens, no visits home to loved ones, just walls and cold hallways to walk down. I bet some of you have loved ones in one of these facilities.
I'm sure you do. Or you know someone who does. This is why I decided to come to Little Rock and support Representative Mayberry's HB 1061 or No Patient Left Behind. After reading this bill, I think Representative Mayberry has made an all-important first step in addressing some of the above problems I've observed in long-term care and their dealing with COVID-19. Anyone not currently carrying the virus should not be limited to access to a loved one and should not be penalized, nor the patient be penalized. I cannot see any reason that reasonable minds would not
vote this bill out of committee. It is obviously Representative Mayberry's observation, as it is mine, that the measures taken in trying to prevent the disease have actually created even worse results than the disease itself. I personally feel you could go even further by allowing those with no symptoms of the disease, the ability to touch or hug their loved one. But how do we eat an apple? We eat it one bite at a time. This bill at least starts us towards putting the patient's needs on equal footing with safety and starts an all-important dialogue that I feel is long overdue.
I'm sure a lot of you have a Beverly Driesle in your life, a mother, a father, or another loved woman in one of these many facilities mentioned in HB 1061. I know I'm not alone in thinking that no one should be denied their dignity no matter the situation we find ourselves in be it a pandemic or other national emergencies the state tells us are pressing those who are residents of a nursing facility long-term care hospitals assisted living or a myriad of other facilities in this state whereby no fault of their own a valid living breathing human being is being cared for are
entitled to the right of a loved one or a designated care provider pastor or other person to be by their aside in time of need. When you're considering your vote to bring this out of committee, I just ask for one thing. I ask for you to whisper the name of one of your loved ones that may be affected by this, and someone you know that is. I think this will help you in making the right decision on this bill. This bill isn't money. This bill is people. It's a strong start, but without your vote, Beverly Driesel, my mother, will still be alone most of the time, and that's my concern
today. My prayers are with those affected, and if my prayers are answered, you will send this bill to the floor with maybe even my request today. This is not for me, for the humanity around us. HB 1061 should be an easy yes vote for all Arkansans in need. Let's be the leader in America and show them that no patient left behind is more than a catchy phrase. It's the right thing to do. Thank you. Thank you, Doug, for
your comments. I apologize for not recognizing there, Doug. Thank you. All right. Committee, that's everybody that has signed up to speak for or against the
bill. I know that you all have a lot of questions. Representative Mayberry, if you would sit there, I've got a suggestion. We need to be out of here. I mean, we've got to go to the session. I was going to cut this off at 12. It's getting very close to that. If we start questions, we're going to go beyond 12. So what I would, I mean, it's obvious that we need to do something. To me, it's obvious. I won't speak for anybody else. But, you know, we all have these stories.
I have one. Everybody has one. Either someone close to them or someone they know. There's no doubt about that. And we need to do something about that. But there are concerns that have been raised. What I would suggest, if you agree, is that we go ahead and pass over this until next Tuesday's meeting, and you come back next Tuesday. And in the meantime, you know, I'd ask committee members to talk to Representative Mayberry and others in the agencies that have been here, and
Surely, surely we can find a solution to this that we can live with. I totally understand the agency's positions and the money lost from the federal government, but surely we can find out a way to work with our federal
Speaker 300
2:09:44
government. Would you agree to that to come back on Tuesday? I
Representative Julie Mayberry
Unverified
2:09:50
will take your lead as chair. I respect that. I want to make sure that everybody on this committee knows that I want your input.
Let's work together on this, willing to make amends to push this forward. But I also want you to keep in mind, we don't represent agencies. We represent the people. And it's the people of the state of Arkansas that have brought you here. And I think their request needs to be put
back into, again, balance in what we're talking about. We, federal law is actually on our side.
Guidelines aren't. But the law is on our side, and they have, a patient
has a right to have someone there. Okay, members, we've got
10 minutes, and I'm going to let you talk. But in 10 minutes, I'm cutting it off. So Representative Allen, you were first, so you go
ahead. You good? Okay. Representative Boyd, did you have something? Yes, I
Speaker 143
2:11:01
just wanted to throw something out for Representative Mayberry to consider,
and it would be totally up to her, but just it's a thought, and it's that, okay? I don't want to micromanage your bill. but that said I'm going to say a lot of my concerns would be alleviated if we actually had two bills one to address long-term care facilities and one to address hospitals and other health care facilities and then we could really get to the you know cut to the chase and figure out what's going on again I understand your bill I don't want to micromanage it but
Representative Julie Mayberry
Unverified
2:11:36
that would help me thank you. Can I can I comment on that? Senator Davis and I were just talking about that. And I think that we will look at that option. We'd love to have your feedback on that. Again, you're the committee that's going to be approving this and helping us, you know, bring this to the House floor. So if that would make things clearer, then we certainly would consider that. Representative Gray, you're recognized. Thank
Representative Michelle Gray
Unverified
2:12:06
you, Mr. Chair. And just to reiterate to
on representative boyd's point and i don't know that you need two bills but maybe just separate sections or somehow we got to figure out separate these out because they do function differently um one of the other things too and i know i talked to you for quite a while yesterday and i appreciate your time and thank you for adding that small amendment but the one thing i do want to point out is that that says that the um it does not affect the rights of legal guardian or holder of a power of attorney but because of where it's at in the statute it doesn't actually carry the weight of what i had intended so if okay if we could get that in the right spot i'd
Representative Julie Mayberry
Unverified
2:12:40
appreciate that um that's probably just in a rush to hurry up that's i know because it was so and if we needed to clean it up we would have done so but i wanted to let you know we were trying
Representative Michelle Gray
Unverified
2:12:50
okay so and then the other thing i just wanted i did mention to senator davis just a few moments ago and i know we talked about this um because i think i don't want to speak for everyone on the community we're all sympathetic we've all had family members in the hospital or in a nursing home and we we want to help right we do want to and we just have to make sure that they say the devil's in the details we have to make sure we get it right so we don't inadvertently hurt anyone
one of the things that i did have concern with and i've read it like i'm not lying a hundred times to try and get it right in my head but where we talk where you talk about um the least restrictive like if i were to follow least restrictive that would bring me to the federal statute which would then put me out of compliance with cms so it's almost like we need to be following we have to follow the most restrictive because that's what we're being held to if i'm a nursing home or a hospital that has federal guidance but then you have to figure out in the most restrictive environment which is what's been
forced upon you how to be as lenient and creative as possible that's why i said i've read it though like so many times trying to make sure. I understand your intent, but your
Representative Julie Mayberry
Unverified
2:13:58
wording may be backwards. Well, the CMS guideline, the most recent one, let me just kind of read that when we talk about guidance. And this is what I mean by least restrictive. You know, you've got from here to here. And what the hope is, is that you go, what allows more visitation rather than what allows the least amount of visitation. So the current guidance right now, it says visitation
can be conducted, can be conducted through different means based on a facility's structure and residence needs, such as in residence rooms, dedicated visitation spaces outdoors or for circumstances beyond compassionate care situations. And I don't want to bore you with all the details. I can send this to you. Anybody who wants to see it, I'll forward this to you. This is actually the current CMS guideline. And I read this and I go, well, why aren't they already doing these things?
What I'm hoping is that we give the energy to the nursing homes and the hospitals to say, look, we can be this strict or here. And we want them here. We want the most amount of visitation possible. And that's what I'm trying to accomplish. I'm not trying to spread coronavirus. I'm not trying to say, you know, don't wear a mask. That's not it. Representative. Oh, sorry. We're running out of time. I'm
going to give a couple more people.
Representative, if you would send that to Mr. Price. Yeah. And
so the more information committee, if you don't want to read it, that's your, but we'll get it information out there if
Representative Joe Cloud
Unverified
2:15:39
they want to see it. So Dr. Cloud. Sent. Representative Cloud, sorry. Thank you, Mr. Chair. Representative Mayberry, one of the ladies that testified alluded to Florida having made some changes and and giving some family members rights and privileges and evidently they did that and they didn't get in trouble with the federal government I would love
Representative Julie Mayberry
Unverified
2:15:57
to know that I will look more into that because when she said that that was sent
to me but when I originally read it a while back I'd have to go back and and look at it I didn't think that it actually accomplished as much as we wanted to but I will definitely go back and look at that I do know that my original bill started off similar to a bill that was in North Carolina in June of 2020. And that's where I got some of the initial language. We've added a whole bunch since then. It went through the Senate. It passed, went to the House and got gutted. And then they
never brought it back to the Senate. So it just kind of died. But that's the furthest of something really kind of like this that I'm aware
of. So I will look more into that. Representative Wayne, you're the last one. You've got
Representative Carlton Wing
Unverified
2:16:44
three minutes. All right. Thank you. And I won't even take that three minutes. First off, Representative Mayberry, Senator Davis, thank you very much for bringing this. This is the right thing to do. This is the moral thing to do. We absolutely have to change the status quo. This is mainly also for the people who are watching online and for those people who
came and testified today. In the eyes of the public, hospital and long-term care is probably the same. But in the eyes of government regulation, it's different. And so I just wanted to assure you that we will work with and assure you that we will work with these people to get the best solution possible so that we can take care of these two very different facilities, but achieve the overall goal, which is what you're trying to do. So I thank you for that. And I thank you, Mr. Chair. So
would you yield your 30 seconds back to Representative Payton?
Speaker 43
2:17:34
Representative Payton, you're recognized. Thank you, Mr. Chair. We have the votes in here to pass this. I'm saying this for the agencies that you're going to be negotiating with. I'm
Representative John Payton
Unverified
2:17:48
like Representative Boyd. Maybe you should have two or three bills. Preserve the really good one that was gutted before this amendment and that was
Speaker 43
2:17:57
not gutted by the next amendment. Preserve that for us. Because if they won't negotiate, we'll pass it. Thank you for bringing this.
Thank you. All right, Representative Mayberry, thank you for bringing the bill. Thank you, committee, for your patience and for discussing this, and we'll talk about it next week. We are adjourned.
Agenda
REGULAR AGENDA Number Sponsor Subtitle
HB1061 J. Mayberry TO CREATE THE NO PATIENT LEFT ALONE ACT; CONCERNING VISITATION RIGHTS OF PATIENTS; AND TO DECLARE AN EMERGENCY.
HB1212 Ladyman TO AMEND THE DIVISION OF WORKFORCE SERVICES LAW; AND CONCERNING THE NONCHARGE OF EMPLOYER CONTRIBUTIONS FOR CERTAIN UNEMPLOYMENT INSURANCE CLAIMS; AND TO DECLARE AN EMERGENCY.
HB1322 Holcomb TO AMEND THE TIMELINE FOR EMBALMING A DEAD BODY IN THE STATE.
SB21 D. Wallace TO EXCLUDE MILL SCALE AND SLAG FROM THE DEFINITION OF “SOLID WASTE” IN THE ARKANSAS SOLID WASTE MANAGEMENT ACT AND THE SOLID WASTE MANAGEMENT AND RECYCLING FUND ACT; AND TO ADD A DEFINITION FOR "MILL SCALE AND SLAG".
HB1068 Pilkington TO CLARIFY THE TELEMEDICINE ACT; TO SPECIFY THAT THE HOME OF A PATIENT MAY BE AN ORIGINATING SITE FOR TELEMEDICINE AND THAT GROUP MEETINGS MAY BE PERFORMED VIA TELEMEDICINE; AND TO CLARIFY REIMBURSEMENT OF TELEMEDICINE SERVICES.
Documents
| Title | Type | Pages | Source |
|---|---|---|---|
| Agenda — PUBLIC HEALTH, WELFARE AND LABOR COMMITTEE- HOUSE, Feb 2, 2021 | Agenda | 1 | Official source ↗ |
Speakers
Representative Jack Ladyman Chair
Unverified
Representative Kenneth B. Ferguson
Unverified
Representative Fred Allen
Unverified
Speaker 19
Speaker 21
Representative Deborah Ferguson Chair
Unverified
Representative Justin Gonzales
Unverified
Speaker 29
Speaker 28
Speaker 23
Speaker 39
Representative John Payton
Unverified
Speaker 47
Representative Carlton Wing
Unverified
Speaker 54
Speaker 55
Speaker 60
Speaker 71
Representative Mike Holcomb
Unverified
Speaker 75
Representative Johnny Rye
Unverified
Speaker 98
Speaker 99
Speaker 103
Speaker 107
Representative Aaron Pilkington
Unverified
Representative Jim Dotson
Unverified
Representative Michelle Gray
Unverified
Representative Justin Boyd
Unverified
Speaker 143
Representative Julie Mayberry
Unverified
Speaker 156
Senator Breanne Davis
Unverified
Speaker 158
Chair
Unverified
Speaker 167
Speaker 176
Representative Josh Miller
Unverified
Speaker 184
Representative Jeff Wardlaw
Unverified
Representative Joe Cloud
Unverified
Speaker 218
Speaker 222
Speaker 225
Speaker 223
Speaker 43
Speaker 237
Alan Floyd
Unverified
Bill Pierce
Unverified
Speaker 258
Speaker 259
Speaker 261
Speaker 263
Speaker 265
Speaker 273
Speaker 274
Speaker 242
Michael Comet
Unverified
Speaker 278
Speaker 279
Speaker 280
Speaker 282
Renee Mallory
Unverified
Naveen Patel
Unverified
Speaker 37
Speaker 106
Speaker 292
Speaker 297
Speaker 300