Public Health, Welfare and Labor Committee- House

Ation I know some of you all showed up this morning. Over on the second floor we will have pictures Tuesday at nine fifteen. On the second floor capitol rotunda. there was a tax that went out with that change but then get some folks so we need to tweak our group. Text process and will do that so I apologize for not getting the message to you all. Okay we have on the referred list we have thirty nine Bills I checked this morning our committee and other committees and it it appears to me that this is a problem and all committees that we're not we're not getting these bills on the regular agenda so these are going to stack up at the end so we really need if your bill is ready to run in here if you have a bill please text me and tell me that you want your read on that bill and I need the you know the date you want to run it is a controversy or not how long will it take to run the bill approximately and the number of people you're going to have here to testify so I need that information and we really need to move bills bills on to the regular agenda otherwise it's going to get really long we have some really long days at the end I may be communicating with each of you individually not taxed on bills to see if I can help you get those on our agenda because we need to use this time we got right now because we won't have time later on so thank you for your help. On that in advance. Okay I think we're ready to move on to the agenda. First item on the agenda Representative Dotson. H. B. eleven ninety five you would go to the table. And if you have any witnesses have them come up with you. All right you would please a. Again for yourselves the record. Thank you Mr chair Jim Dotson state Representative and with me is calling McCrory he's an expert on this topic you're recognized to present your bill represent thank you Mr chair members the committee and bring the before you head house bill eleven ninety five the every mom matters act or E. M. M. A. Emma for short appreciate several of you are also co sponsors on this bill Well do is I'll try to go through and briefly go through the bill quickly and then have any questions and and Colin will be great for resources well to answer those as as you have them First I mean the overarching goal goal of in the he is to reduce abortions by making sure every woman obtaining an abortion in Arkansas knows about the resources both public and private available to her to support her pregnancy. And parenting should she said decide not to have an abortion. M.. That's that's it basically in a nutshell Tom is many abortions are driven by socio economic concerns that pre existing pregnancy many women seeking abortion experience heightened stress are unaware of the resources available to them. the current process is inadequate to get them the information they need to know to make that decision In the remedies these inadequacies so that it does that by requiring that before obtaining an abortion a woman must first receive a free resource assistant access assistance offer from a train supported professional in which the professional explain services available to the woman and offers to connect her directly to them the Bill supports extensive follow up services until the child's second birthday all services are provided through a brief phone call to a toll free number Data shows that if women are fully informed a third of them will decide to keep their babies in Arkansas when Emma is fully implemented that would be roughly a thousand babies saved annually on an ongoing and ongoing support to the children's mothers obviously there is going to be a cost to this the estimates best estimates we have based off of similar type programs in other states is this will probably cost the state of Arkansas to address the the subset of the population that are seeking abortion between one point two to maybe one point five million dollars but imagine if you will with with me five years after this goes into effect. we will be seeing the equivalent of forty plus new kindergarteners going into schools across the state that's the result of this a thousand babies per year save translates into over forty new classrooms of kindergartners each and every year thereafter and I'll be one take any questions. Resent of cloud you're recognized for a question. Thank you Mr chair thank you Jim just a question where is the money come from GFR so this would be a policy decision if we decide to move forward with this this would be the law that the department health would begin the implementation process over the next year and a half to two years I guess it it begins January first twenty twenty three isn't when it will have to go into effect so they'll have basically the next. Well almost two years to to fully implement it so over the next couple of years. Your budget growth and budgeting will will have to make those decisions but this is a policy decision if we make the policy decision will have to incorporate that into our ongoing budget in years to come it's it's not gonna affect the budget this this fiscal year for half of the neck into half of the next fiscal year. Represent the board you're recognized. Thank you Mr chair I just wanted to I want to stay focused on this bill that's what's appropriate but at the same token this bill going forward could affect other places so have you considered also filing you know and appropriations to increase in the amount of money that appropriated for foster care and and things like that that's not necessarily within the scope of this bill we're we're continuously evaluating those things when it comes to appropriations and budgeting so those things will obviously be a consideration for Joint Budget Committee primarily over the upcoming years I said it won't directly affect us in the the immediate future but as years come yes we'll have to address those needs as we see how how this program is is utilized. Then your question is invalid one follow up real quick you're recognized would you be open to working with me on joint budget and looking at the application after we're done with this thank you. Represented Ferguson you're recognized for a question. Thank you Mr chairman at five I guess I need a little of information that I thought I remember didn't represented Crawford passed this life lines program last session cut kind of remind me what that bill was of what that established for this program so that was yes yes in this amends on to part of that if you see at the very beginning in the bill it is referenced and modified a little bit that program was designed to be more of a advertising out reach to all women in the state that might be seeking abortion this is much more narrowly tailored to just those who are are at. Basically in the first steps of actually trying to obtain one so you're talking about a much smaller subset we have roughly three thousand abortions a year in the state I'm not sure exactly how many of them go to their initial visit and then currently fallout before obtaining one but you'd be talking about all those that would be actively seeking one Being required to make a phone call and it happened have the the Have that resource resource access to systems offer provided to them so they know what services are available to them before they could follow through and complete the complete the abortion after the seventy two hour current waiting period that we have I guess my question is do we make that part of the health department or is it a separate nonprofit well yes the the Life choices lifeline program that we set up it's part of the health department but it was a they may do this we never required them to do this and so it's been two years and they haven't moved forward with it so it it's actually not an operation that I guess that was my question just physically would we data or if pay if it's a independent nonprofit or if it's part of the health department already and yes Is part of their budget right the health department would be the lead on this and the way that this would work is they would contract out with with various folks that have the expertise and resources to take the phone call I mean health department on the eight hundred number that that they would call in but then they would route that that number to one or multiple organizations that they contract with in order to provide this information to the to the women seeking an abortion in getting that that offer those professionals on the other end of that call within make the offer make sure she knows of all the resources available and check the box so to speak that she's received offer at that point you can move forward with an abortion or she can ask for more information or to be connected directly to a specific source and they can connector to whatever resources she needs in her purse particular situation with that that are already available in out there whether it be child care services whether whatever her particular situation is and tailor Care Act care plan specifically for her going forward should she choose to not continue and go forward with an abortion I have a few more questions but in come back to me. The represented Payton you're recognized for a question. Thank you Mr chair Representative Dotson with a focus like this on resources both public and private. Do you think that I mean we're kind in court control of the public resources and I think it could increase those but don't you think the bill like this and the focus it brings might increase the private resources available to women that are seeking to keep their child I mean I think it has the the potential to do a lot of things in particular I I think if if you really look at the economic impact of an individual over the course of their lifetime if we have more individuals that are being born growing up going to our schools at getting jobs producing being part of our economy and having kids themselves of the course their lifetime. Every individual that is born has a tremendous amount of economic potential and that is added in a rich is our state fully those those costs of services to help them kind of get started if you will that we we invest in every every child in the state We're talking a very very small addition to that in the four hundred and. Seventy nine thousand K. through twelve students that we have a year over the course of years it's it's a relatively small amount but it is a large amount of reduction and abortions well absolutely center. Yes Chrissy and I agree of. You know it makes sense. Economically that we would. Want these children to become productive members of society. But just emotionally you for having three thousand abortions a year to think that some of those mothers might not have been informed about the resources available and I found out later that these resources were available and they have it's too late they've already had the abortion just emotionally I think this is an important bill I appreciate you bringing thank you. Your Ferguson you're recognized yeah and I just you know seventy percent of our births in Arkansas Medicaid is a part of this program to help them access Medicaid and health care resources yeah that would be both the private and the public resource I mean that would be part of the public resources that are available thank you that was currently out there I mean these are resources that they can already access just oftentimes they're unaware of it and so making sure they're aware of it before they take a step that is reversible hi I guess my other question is the auditing and finding of the. A does that include expert OB offices of Maine will they have to report who all has to report to avoid defined any provider who would be performing an abortion would be required to to verify that the woman has received this offer before they can move forward with an abortion or be at subject to fines if if it's determined that they are not in the verification process is set up by the department of health and if you look through the details of the bill there is an auditing that provision in there that any abortion provider has to have their records at ten percent I believe. Is that right you might jump in here for ten percent of the total records of any abortions they do so they do a hundred or if they do it three thousand ten percent of that Santa sampling that has to be audited on an annual basis if there's a five percent discrepancy in found in that way they're not then they would do an audit of all of their records for the year to make sure that they're they're in compliance with this but it's only abortion providers it's not OB offices was any having to or they're not they're not they're it is referring for abortion I don't have to do is that right if if an OB is referring to an abortion provider yeah it would be the provider not whoever's performing the abortion that's yeah. I guess my other question is so someone is you know really knows that they want to have an abortion how much will this delay that process for them if they decide they don't want to do like one. It requires a five minute phone call phone call could be complete in five minutes and additionally she does not mom is not required to provide any personal information and she is not required to take on any follow up services to be accomplished in five minutes well in in in our I hope this doesn't just the lady of hi I'm I'm for not encouraging abortion but I hope it also helps with what represented Bentley that worked on submit to that surely improving maternal mortality and infant outcomes is not just avoiding abortion but actually making a change for these women. I would refer to section twenty four seventy three that requires that this be completed the same day so that the process would get done and then the day of the call I wouldn't delay with the seventy two hour waiting period it wouldn't delay so even intentionally baked in some safeguards to make sure it's not gonna result in a delay. Thank you. Representa Bentley you're recognized for a question. Thank you chairman calling can you share this with how this is work in some other states that we've successfully done this already so give us some feedback of what you've done so far and some other place thank you Representative Bentley I work for an organization called him coalition which operates Social support services for pregnant mothers and several states across the country the the contents of the support services follow up services are involved in this bill are very similar to what we provide in Texas over the last two years we've supported a ten thousand five hundred mothers in the state of Texas around the decision around the needs related to the abortion decision the pregnancy or abortion decision and approximately a third of those mothers have once they've all been offered and accepted resources about a third of those mothers have elected to keep we've confirmed at about a third of those mothers have elected to continue the pregnancy and I believe that the average The average mom will work with the organization for about five months so well into her pregnancy dealing with a range of issues from first getting obstetric care signing up for Medicaid and squaring away some the pregnancy health needs to than working on. Job training resume development and improving the economic situation for the family. Thank you. All rights saying no more questions are there other questions from the committee. All right. Thank you all for your. And put their we have one person who is here to speak for the bill. Of rose McGowan's. Yes ma'am if you want to speak please come forward. In addition to serving the represent the record. Good morning I'm Rosemary executive director of Arkansas right to life thank you Mr chairman and members of the committee I'm just here to tell you this is a pro life bill Arkansas right to life supports it we encourage you to vote for it this will go a long way in helping to reduce the number of abortions in Arkansas. It is somebody who has spent five years working as a counselor at a crisis pregnancy center. And all a woman wants when she's pregnant is to have somebody support her in her decision and to give her what she needs the most. And you know it might be just Telling her you know giving her referral to an OBGYN are to tell her how she can sign up for Medicaid if she needs that you know just whatever she needs and so many women who have. Thank that abortion is a solution to the problem don't have all the resources that they should have to make that informed decision that life and death decision so even today in my office in Arkansas right to life I get calls from women. That are seeking an abortion. And they are tragic calls because many times these are young women who have one child already and find themselves pregnant and they're poor they don't have a they don't have a husband generally that a boyfriend and every voice say here is telling them to have an abortion that'll solve your problem. And just to have these resources on a five minute phone call to tell them we're here for you we want to help you what do you need that will go so far to help many of these women who do not want to have an abortion in the first place but they just don't have the help that they need so really encourage you to vote for this bill. And to think that it would stay but thousand babies in Arkansas. That just touches me deeply in that now that you all our love life they want to protect life and this bill is is going to do that are firmly believe that so please vote for this bill thank you represented when did you have a question or comment. You're recognized. Thank you Mister I just wanna make sure I heard the number correctly that as many as a third of the people who will make that five minute phone call will change their decision and and and to choose life instead is that correct they could you know and that's that's the we don't know until this bill is passed we start you know being able to count them but that's what Colin testified to that in Texas a third of the women that came of you know got that information that were abortion bound to change their minds and you know that's what we're all about changing minds and hearts for life. That sounds like a valuable five minutes thank you very much. Thank you this man three comments of. Mr mat do more you're on this list did you want to make a comment or. Please introduce yourself. Matt Gilmore department health can you hear me yes. Thank you Mr I just want to speak on the bill are we a visit with represented Dotson and his guest Collins appreciate their time and trying to explain to us how they envision it working the cost is a factor we're gonna have to. Figure out We did some estimates on our side we're looking potentially close to four five million others that quite a bit less when I visited with Colin yesterday one the numbers mission was around two point one eight based on their estimates so we are looking at the cost of this They mention as well you know twenty twenty three being implemented so that wouldn't affecting of the current budget but since we're going to come into play later on. one more thing as far as the so it would affect the other budget the future but as far as the contracting part of it typically we can do things in house sometimes cheaper no that's not what people think about state government but we have done things with our PDMP our suicide prevention line and we can keep things in house sometimes cheaper but just want to mention those comments deal and I have a second question that I can help with. Representa Wardlaw you're recognized for a question. Thank you Mr. I got a couple questions if you'll let me I need him to answer a couple to get there. So you said to do this is for five million I hear you correctly based on our estimate with programs we've done in the past had you come to that estimate so we looked at our PDMP and some of the data bases in the contract and we've done with the in house and outside factors we've also looked at or suicide prevention line are tobacco line as well stop you right there is so what ticks me off is when you guys don't want to do something you come in here with a five million dollar price tag you come over there they'll see every year four eight hundred thousand dollars for a quit line that we get nothing out of. Zero don't save a life. You can't give us any numbers or anybody actually quit. This is aggravated. So before you come in here those big numbers again let's make sure they're correct thank you Mr. Saying no further questions. A. Represented Ferguson you're recognized a yeah this may be a better question for DHS I I do think we have to consider the fiscal impact I think if the program works effectively it can be very beneficial to women at have they looked at the DHS impact for if a third of seventy percent of these thousand deliveries are Medicaid. What would be the fiscal impact on the DHEA agency and for the pregnancy and delivery and child abated we looked at that. Medicaid impact I have not the. At DHS question we have looked at you know services I think that we are aware of in the state. That we that are here currently I think we could work with those I think there's ways to do some things in house but as far as a services that are referred to I mean I think a lot of these individuals are probably getting some of those services now this would just be a way to connect them to that. Well a and I'm I'm for you know saving lives in women not having abortions but I think the bigger thing is we need to be prepared to support these women long term and their children I mean it's it's a much bigger thing than just saying yeah we're not good they're not going to have an abortion I mean we really have to look at the long term of implications and are we as a legislator willing to support these women and children like they should be if we're going to help save these children. Thank you. Thing no further questions thank you for your comments thank you. Right percent of Johnson are you ready to close. Thank you Mr chair By may. Have Allen go through a couple of the numbers that might be. Actionable anybody's mind yes based off of what we just heard. Proceed. Thank you as I mentioned earlier my organization provide services very similar to what would be provided through this bill in Texas we've modeled a cost for the service portion of this that would include the resource access assistance offered the care plan coordination and healthy pregnancy pregnancy program services we model of of financial estimate of around one point five million one point two to one for one point five million depending on a different adjustments that are made in the program that's based on our existing conversion rates in our program in Texas as well as the the length of time phone calls take the length of time with a nurse the length of time with the social worker the number of visits that are made and the existing data over the last two two and a half years. on the second there's a second issue there that the Department raised about bringing services in house the the follow up services provided through this are general social services those are I think many organizations the state can provide those. The initial phone call is a critical hot button time sensitive Five minutes it's a very important five minutes that has to be handled just purposely that's that does take some expertise that I I I do believe we need to bring and organizations I have experience providing those services to handle that phone call for to be effective. The. There's also mentioned yesterday of a at two point one eight the department's testimony mentioned but discussion of a two point one eight number the state of Texas appropriate surprisingly forty million dollars a year for the alternatives to abortion program so the two point eight was actually preparation based on the relative number of abortions performed by performed in Arkansas to the number performed in Texas of that forty million that was not a financial projection based on the specific program and in this and sent out of it that's just a preparation of how much the city Texas provides for services similar to this. So thank you members the committee I appreciate the opportunity to bring this bill before you and I think you've heard kind of all the different sides of it I appreciate all the comments the questions are made basically this boils down to a policy decision as far as the resources are concerned we will we will as we do every year work to figure out the Budget flow and how things go the the bottom line question that you have to ask yourself is. Before this goes into effect we're having around three thousand fortunes a year after this goes into effect if one out of three women change their mind we would have thousand fewer abortions they may. And there's experience that shows that in in other states and so. I ask you to consider that and I would appreciate a good vote. I make a motion to pass. Okay you have a motion on the floor to pass we're in the discussion face of you have a discussion let me know but I have a comment As the presenter said this we're having a policy discussion here not a financial this is not the Budget Committee and I just as I said here this is a really good debate and as I sit here and listen and think about this what came to my mind was if we knew that we were gonna lose a thousand lives. Don't think about the age. Weather's minus one month or plus ninety years if we knew that we could save a thousand lives a year. From a natural disaster. Would we be willing to spend two million four million dollars I think we would so just think about it this way. You know we had the Arkansas River flood couple years ago that was tremendous flood we had a tornado go through Jones were all they could have easily taken hundreds of lives did not but if we knew that Arkansas River was not a flood every year and kill thousand people. We spent four million dollars putting levies I think we would. So we should think about the policy here in the lives that could be saved and could be productive. Now the other side of that some of those lives will not be productive they will be a negative impact on the in the economy. As it is today. But the overall impact on the economy I think would be very positive. so that's that's my comments or the internal other discussion. Seeing none all in favor of do pass signify by saying aye. All opposed nay. Motion carries graduations represent thank you Mr chairman members of the committee. One two H. B. eleven eighty represented Gonzalez. Everybody. Representative you're recognized thank Mister of committee is just one of those little bills The New much. You have any questions on it I'd be glad to take a. No this bill it I don't there's no opposition that I know of what what it does is there's a found out of through the interim we jump through hoops to change scope of practice legislation here boards can can do that on health care policy without having to jump through the same hoops this would just may add one more step to the rule making process that if the board decides to change scope of practice that comes before this committee before it it continues on through the final rule making process I had been contacted by anybody as opposed to. But the. Represent first recognized I guess some of little confused because boards don't change scope of practice day right rules in response to legislation that changes scope of practice so I. They. They actually can change scope of practice and we had a rule what is my practice botox rule that came up in the interim that could have been seen as a scope change of believe that if we would have done that here it would have been your rules a scope change would have to have a nice B. it would have to set on the table for two weeks before we can run and all those things but they don't have the they don't have the same. Restriction on them and this is not adding that same restriction is just simply saying Hey if you if you do anything that's perceived as a scope change just send it to the public health committee before. Because there is finally LC rulemaking. The FBI I didn't per se that is a scope change I think they were just defining right scope was becoming just to be clear boards don't change scope of practice they respond with rules to what we change got practice. And any other questions from committee. Seeing on represent a re read to close. clothes make a motion to pass. I have a motion do pass in discussion on the motion. Seeing none all in favor signify by saying aye. All opposed nay. Motion carries graduation representing your bill as fast. All right moving on next item represented Wardlaw H. B. twelve twenty seven. Representing you're recognized would you please give Senators ourselves thank you miss chair of the wood Tyler. I'm Tyler majors vice president human resources at PAM transport in Tontitown Arkansas represented you're recognized for the bill Mr chairman back in the fall of Mister taler brooch me and I'll tell me about any issue they were having in the trucking industry and now being that I ship a lot of tomatoes across the country I got to thinking about it and thought it might be glad to sponsor that bill is a new a little bit about sleeper Burson trucks. So the the impact this bill is very narrow addressed in this it forces specific scenario the legislation doesn't change anything and custom prior in their normal everyday practices As required by federal regulations drivers must log on duty time and task and obviously that includes driving fuel in loading and unloading. All these are normal activities and will remain comprehensive What this bill really addresses the off duty time and what it says is that we don't have to calculate minimum wage during that off duty time and we don't do that today it's not practice of but there are some places where that's coming up the average truck driver today in Arkansas brings home about thirty eight thousand dollars a year today and they receive per diem in addition to their way just so they have sent a loading dock all day they're compensated for that because obviously they're not collecting any miles most of them get paid by either miles or percentage of the load is how their how they're compensated. Of. And with that I'd be happy to take any questions from committee. Are there any questions from the committee. Assaying nine we have another person signed up to speak for the bill. Is that Tony Rosa. Person here. Okay. All right so represent if you're ready to close in I am under a. Create a good vote and I'll make a motion to pass all right and the motion on the floor is do pass any discussion on the motion. Seeing none all in favor signify by saying aye. All opposed nay. Motion carries congratulations representing your bill has passed thank you Mr chairman and next time a vote no it won't be before I run the bill. All right committee that's all that we have on the agenda for today and again I want to remind you to text me we need to get your bills on here so that we