Public Health, Welfare and Labor Committee- House

So apartment health at the start of the the current coated pandemic and then I was asked to be interim secretary of health when a Nate Smith went to the CDC and then the the governor granting me the honor and privilege of serving as the secretary of health and of permit position until at his pleasure so I'm a little bit about what we do I think also if you've had some interaction with us either directly or indirectly since the beginning of this pandemic in March but it in addition to dealing with issues directly related to the pandemic we have a lot of the scope of influence at throughout the state so we have programs in chronic disease we work with the trauma system to work on on not a trauma con. we also are involved in the immunizations for children and adults flu vaccine annually and pneumococcal vaccine for adults are the scope of work also includes in water safety food safety regulation of a a number of of the boards of of practices such as beauticians tattoo parlors that centralization of the the ones that we do and we have a lot to do with with issues related to the covert pandemic at this time. So I think that's it a general overview I can go deeper and if if the committee wishes five as the I'd like to tell you a little bit about what we've done with our covert vaccination because I think it's a foremost in a lot of your minds and and then if if the committee wishes and the chair co chair wish we can entertain questions so At this time as of this morning we have but distributed one hundred and twelve thousand two hundred thirty eight doses of vaccine that's one one two two three eight yesterday we received a large amount of vaccine from the because we receive our vaccine towards the middle and last letter part of the of the week so as of today hours or receipt of the state this section of the of this the vaccine is two hundred seventy five thousand doses there we also receive we also take into account the vaccine that is given for the vaccination of the residents at long term care facilities and the staff at those facilities so although that does not always come to us you can go to pharmacies it's counted as part of the state's allocation for code vaccine and so that at this time uh we received they have received forty nine thousand four hundred doses of which of four thousand five hundred and thirty four doses have been administered at the nine point two percent and just as a point is so yesterday based on the numbers that we had at that time they had administered sixteen point nine percent so you can see that that's going to fluctuate as we receive new doses from the federal government when we combine both what the state receives and what the L. T. C. F. which is the long term care facilities receive we have received a combined total of three hundred and twenty four thousand four hundred doses three two four four hundred three two four four hundred and we've administered one hundred and sixteen thousand seven hundred and seventy two doses one one six seven seven two seven seven two so M. when we look at this as a percent of a distribution that is thirty six percent of the total. That's what has gone out as being it Mr in the arms at this time. yesterday based on these numbers of yesterday I have not looked at as at today we had administered approximately we had immunise approximate three point five percent of our state NO national basis that places as that places us at about nineteenth audit from the top at the of the of the states and jurisdictions covered by the US centers for disease control there fifty nine of these. so I present these numbers for your interpretation if you wish I can go into in the greater detail quickly then as co that has it impacted the hospitals and is impacting more we are in a surge upon a surge and I'm afraid that there may be another surge as the new year's holiday activities start to deal more cases so as as of today we are ICU bed capacities of four percent our total bed capacity is at twenty one not one point nine and a ventilator capacity is that the fifty six point eight percent. So I'll stop there and see if there are any specific questions you would like to ask at this time thank you for the doctor marijuana I'm not going to open up for questions because the we have other agencies to present on trade we might go along if we do that but but just a couple of things I know that people are interested in changes that I think have taken place of we are going into the one B. category on Monday as Ford's vaccines and then also I heard that the the the basically the fifty percent hold back for the second shot that has been changed so you're not holding that as a second shot because the the distribution the pipeline is full so is that true and you just spend a few minutes talking about that I would be happy to answer so so um mysteries are the came out with a change in the current administration's plan for distribution currently to me prior to this the the plan was to release approximately fifty percent of the vaccine available to the United States for distribution the federal government kept back of fifty percent of the dose in reserve for second doses and a five percent contingency so fifty five percent was held back so what is now currently in in in place is to get out all of the axing at one time and not so much worried about getting that second dose assuming that the manufacturing capacity of the two vaccine companies that are now out of now you a approved will keep up with that so so a in addition to that he made two recommendations that was first to open a vaccination two sixty five and older individuals sixty five and older. Regardless of whether they had medical conditions or not and he also made the recommendation for expanding vaccination to those individual sixteen years and older who had a comorbid condition identified by the CDC as placing them at greater risk for morbidity or mortality due to covert so our governor that has review these these recommendations with me and the current plan for the state is to lower the age from seventy five to seventy which was originally his thought for phase B. and we will not be including the group from sixteen to sixty five at this time we will be entering phase be officially one B. phase one B. officially on Monday of next week. Focusing primarily on individuals seventy five year seventy years sixty seventy years and older. Adam and then the individuals in education so K. through twelve. University and daycare and the staff related to those to those institutions so that is our plan at this time I I I I do not speak for the governor on this because this is the decision that he has not made yet but I suspect that as we receive more vaccine as we continue to get this vaccine out we may shift some of the groups around depending on availability of axing again this is just my thought and how I would look at this in advise the governor because I me see myself as his adviser If I if I can parenthetically say I believe we're doing a a good job of getting the vaccine out having the immunized three point five percent of our population so that is good for the time being could we do better of course we can do better and we will push for that but I don't think it's a dismal dismal show if you will as as some have said this is this is good we are pushing forward we will get better and we will begin to expand our delivery of this vaccine past the hospitals the pharmacies eventually into the into large clinics and down into the private practitioner. Thank you Dr Merrill one is the look very last question I have and then the vice chairman Ferguson wanted to make a statement do you have any information on the other companies that are vying to get approval and what the progress is yes Sir so so we we suspect that and I can't mention the name yet but there there may be a licensure for a company is early as March so that would add a third vaccine we know that one of the companies that this is public knowledge that one of the companies that is is vying for E. way these are all you a approved is Johnson Johnson Janssen pharmaceuticals it's faxing actually has the advantage of a single dose and we understand that they are going to be moving forward with an E. way application however their production is two months behind where it should be and so if I if I dress just a bit I think you've all heard of operation were speed operation were speed accelerated the development of vaccines through very safe and the the traditional methods simply putting them in in parallel so that the the faces could be steady and building upon extensive knowledge that we had regarding coronavirus relatives so this thing's allowed the compression of time for the submission of any you a so from from from fifteen years from ten to fifteen years to ten to fifteen months so will it is we also they also either operational or speed also paid for the manufacturer of vaccines at the same time you're conducting phase three drug trials so normally a pharmaceutical company would not invest in developing a vaccine until it has all its ducks in a row and prove that the vaccine was efficacious and that the FDA said you can go for. For here that last step that is that that the final efficacy step and the approval was funded so that we can be I'm sorry that that phase of manufacturers of was conducted during the menu at their last phase phase three and during the E. way so there would be a large amount of vaccine already available if the vaccine was proven to be safe so they're they're behind the ball on that. And we expect to see problems like this but this is not unusual I mean this is an incredible effort by by the by the by private government and and federal partnership. Thank you for that Now tomorrow a vice chairperson recognized thank you add this one all of you to know how proud we should be to have Dr Romero as the secretary of health I don't know if any of you know but you are your you'll have to clarify the exact position but you're the chairman of the CDC vaccine program is that is that the exact title I am the chairman of the advisory committee on immunization practices so that's a fifteen group member fifteen member group of non governmental advisors which have. Quote expertise and quote in in in vexillology I have the honor of sharing that type of that I'm in my third year of that share and will be my final year seven years of experience in it in the in the CDC's role and just parenthetically I also chair the FDA's of vaccine approval it advisory committees called the per pack and so I was a on that per pack for four years plus one year as a chair so I I I have experience through the entire process from from licensure to what the ACIP does is determine where that vaccine can be used effectively the of senior interviews on national television you've done a great job at I do have just one question other state salary and does have a a statewide registry where the you can go online and register and then schedule of acting appointment is there any plan for Arkansas to do that not at present so we we do have the if you will registry for example for our motives of delivering this vaccine to the educators will be through the department of education so that they can take a pulse of what's necessary in a given area and then they can go forward so it again I think it's just an excellent question one of the things that that that it has taught at that I've learned and I. Said very early on in this pandemic is that this is very fluid and it is frustrating I know to the public to sit there and have us change on a dime sometimes but but because we let we are learning so much and that includes not about the disease that just about treatment but also how to deliver these vaccines it It don't be surprised if we do change in the future as to a statewide registry or some other other mechanism it's it's it's not because we don't know what we're doing is because we're learning new things and we need to comply those to our state in order to keep on top of this. Thank you for hard work at and this is this years been stressful for everyone that particular public health thank you thank you. Thank you Dr Meryl we do appreciate your international standing and what that does for state. I will recognize the represented Lloyd he's actually I think maybe the only person in this room is given this vaccine and not thank you might have some good input you're recognized represent board. Thank you Mister chair I actually had a question while we have Secretary Romero right here and I don't want to I'm sorry I'm I'm hiding behind Representative Davis deserve of represented Davis and I have both been receiving some questions about as we move the phase one B. on Monday vaccine allocation for the schools and there's a little confusion so pharmacies have been receiving an allocation you know you you take a survey and he said in the survey result and you say how many doses you think you're going to need the next week and then you know somebody makes a decision whether they agree or not since you that does it so. So the clarity is will say like the pharmacy I work in and out of Arkansas if it talks down the school district down the school district says we need X. number of doses. Would those doses come out of that weekly allocation or is there a separate process for the schools does that am I making sense you'd be where you are as you are is is that on top of what you're allocation is at this time so so yes so I I it will to we would we would submit your request because you tell us what you need we tell the feds what what we want and they give us what they can't so the bottom line is that you tell me you as pharmacists tell me tell the health department no we have this need a vaccine this amount and then we will submit a request the federal government and we hope that the bill be able to ship this out quickly right I mean that's the they told us open the gates so we open the gates let's see what happens with with the flow. So so just to clarify to make sure I understood correctly because were hand are going to I'm sure everybody will get questions but I know represented Davis and I have been so with that pharmacy submits its weekly request or whatever frequency but it's been weekly up to this point we would say we need to say however many doses and that would include what we anticipated needing for the public schools yes Sir as far as I know no I don't I will have somebody on my staff confirm that okay and and get back to you and I wanna clear I'm not try to put you on the spot I just well you we have you right here on No Representative Davis and I have been trying to to clarify that asked right and I understand that that's why I'm simply stating that you know they will keep me honest got it I will send it back to my staff and and have them correct anything that I said Iran is thank you. you. My doctor mail thank you very much for the presentation is one more thing for the new members and I'll ask you so the other departments as well when you come up but do you have a primary contact that you would like folks from this committee to contact or if you do the please let us know or. A Mister Gilmore please Mr Gilmore we are primary contact okay all right thank you all very much thank you have a good day be safe. All right of the next agency is the Department of Human Services so let's go us we've you've come forward. With your team. And if you would introduce yourself and the members of your team. Good morning you can hear me good morning it can you move that Michael closer the mobile okay can you hear me now that's better yes thank you good morning I'm Cindy Gillespie I'm the secretary of the department of Human Services this is a mark if you to traditions of. The more vital to argument services. And the mark is the chief of staff and chief of legislative and intergovernmental affairs mark is your primary contact along with Kendall Rogers. Kendall is our deputy chief of staff so I think most of you have met what are both of them over the month the film look forward to very much to to working with you here on the committee If. I was asked to give you a very quick overview of DHF and so this will be very very high level I know you are all very familiar probably with the Department that particularly for those of you that are new on the committee You will be a. Barker be your primary contact but obviously over the months ahead you will end up working very closely with a lot of our division directors. Our divisions are really grouped into two areas we have what I refer to usually it's our health and Medicaid divisions. One is the Division of Medical Services DMS and that's where we basically a run Medicaid from in terms of payment and policy around Medicaid payment. We also have the Division of of of our county operations and there is a county office in every county in Arkansas and this is where we do eligibility services and it's eligibility not just for Medicaid but Medicaid snap and T. slash ten of our eligibility there. we have then the Division of aging adult and behavioral health services and that division is oversees all of our mental health programs both Medicaid as well as the public mental health system in the state they also oversee the elderly and disabled programs both again Medicaid such as our choices and then are others Where we largely receive federal funding and that triple A.'s of which is that the areas on aging sorry I've always get that acronym confused meals on wheels those kinds of programs which are largely federally funded and then they run the state psychiatric hospital ash and they also run the R. State nursing home which is the Arkansas Health Center so the very large division there we have the division for developmental services this is where we run programs for the intellectually and developmentally disabled This really falls into both a program side as well as running the five human development of the human human development centers the HTC's so again a very large Division that division has. Ruffle over a thousand employees at any one given time in order to run those centres. Then we have the Division of provider support and quality assurance one of the better acronyms unfortunately we ever came up with dips call and it is where we oversee Medicaid providers including a long term care that's where we do the survey at the long term care side so that's the Medicaid side of the house in help side of the house the other side of the house which we refer to as the children and family side of the house although it all connects together is a of the division of child and family services child welfare for the state. A division of child care and early childhood education which is where we licensed daycare and monitor daycare programs we also run. Grant programs there to subsidize low income working parents with daycare and we work on quality improvement and child care again most of that is federally funded. And then finally we have the Division of Youth Services which is where we have the juvenile justice operations for the state and that includes the of our residential treatment centers for the juveniles in the state as well as home and community based programs. Most of the legislative activity and rules activity related to the health salaried will go through this Committee and so there will be a lot of interaction with you about that from time to time there are elements over in of the other programs the other divisions the child and family side that do wind up because of their health connection over in this committee as well so very quick look at who we are. All right thank you for that and again I don't want to really open up for questions because we could go on and we could run out of time quickly I do want to mention one thing to so the committee knows this because I'm sure we'll be discussing this the Arkansas works the waiver will be expiring and I know your agency or department is done a lot of work on that over the past year I'm with you will make a comment about that but but I want to committee members to know that there's gonna be a lot involved in that particular area if you want to just comment or summarize that you're welcome to do that yes Sir thank you yes of among the legislation that would of we hope to bring this year. Will be legislation to reauthorize the R. three Arkansas Works program and allow the state to submit a new waiver request to CMS to continue that program as the chairman said it all expires at the end of this calendar year our focus within the program this time is to set in place targeted initiatives that will help us improve health with a particular focus around maternal and infant health and a rural health outcomes so certain target populations there. We also are looking at some components to slow the rate of growth in the Medicaid costs side of that program enhance personal accountability through economic independence initiatives which does include doing a work education and engagement incentive as a part of it enhance carrier account and provider accountability by having performance outcome requirements and then of really focus again on the rural areas on strengthening the critical access hospitals and expanding access to behavioral health particularly crisis acute behavioral health services in the rural areas through this the very large of proposal we are trying prior to finalizing legislation to bring forward to meet with all the members of the public health committee so we have many of you have already given us a substantial amount of time and we mark and Kendall are trying to arrange meetings with everyone else I I do have to say for those of you who have we've already met with and those of you that will make within the future I cannot tell you how much we appreciate the amount of time you have been willing to give because it is a very large program and we felt like it's really important to be able to both walk through what we're thinking and take input before finalizing legislation so thank you very much for that and look forward to those meetings. And for those who we have met with if you have additional input please reach out to us because we are still working our way through the draft. Thank you for that and you know committee we this is going to be a very important session and and my mind at least because you know we have the pandemic we're dealing with we get re districting but this Arkansas Works a requirement that any legislation required for that will need to be done in this session is or will have to have special sessions I'm sure that's up to the governor obviously but that has to be done in the session basically and and this is one of the big ones that will have to be working on so thank you all very much. All right of next the department is the Arkansas department of commerce. Dr Childress. It introduce yourself and anyone on your team is here. Hello good morning Sri's charters Director of the Division of work for services Alicia Curtis's here as well from the department of commerce if if you have any questions as a follow up you can contact me or Alicia Curtis within the department of commerce so I'm going to shift over to the labor side of this committee but before I do I will I will address one bill that is has not been filed yet unordered um do we have a sponsor yet we've been working with the DHS and and this is the this will be a request are declared an amendment to the current legislation current law to decouple the work pace program from the TV program the T. T. stands for transitional employment assistance and so this will be this could be a bill that this committee hears but this would be allowed on a little eligible family to qualify for this employment based program without having to participate in T. as in eligibility requirement which oftentimes becomes a restriction and limits those that can't participate so we will have we're working on the draft of that bill and working with DHS on that bill so that may be a a bill that that is seen by this committee we are also working with DHS on the Arkansas Works bill. Two other bills that that. most likely will be and state agencies but of course these bills have not been filed either and they are two bills for the Arkansas rehabilitation services under the division of workforce services we have the legacy division of workforce services that existed prior to transformation that operates as a business unit and includes the legacy Division of work for services and are also adult education. Then we also have under the division of workforce services now after transformation of the Arkansas rehabilitation services and also the division of services for the blind they operate under a separate business unit and that is five ten. So those bills to bills for Arkansas a rehabilitation services again are in draft format they've not been filed as of yet we do have sponsors for those bills one is to change the forgiveness of the student loan program so that eligible employees work that that work the required two years and then Search the eligible employees work the required two years and then payments are made to the lenders so there will be a change an existing requested change existing law and then a bill to change the telecommunications access program by allowing the red revenue to build at before areas need to petition for a pause on that surcharge of the funds of for that program so of those bills and the passive gone to state agencies but of course I realize that that's at the pleasure of the leadership of the house and Senate so depending on who files the bill so we will follow those and now to switch over to labor which is part of this committee as well we have some of bills that will be filed soon for division of workforce services one of those has to do with future rates and a non charge for unemployment insurance or employers in the unemployment insurance program the second is a stabilization tax amendment to current law and taxable wage base also an amendment to current law we are also looking at a change to. the Code Arkansas Code that would maximize the allowable disclosure of confidential information by taking advantage of discretion Currently under twenty CFR six of three federal law currently this law our state law limits the disclosure to a list of state agencies and especially in regard to disclosures to public officials so this would maximize the allowable disclosures of that information and would allow us to work with other agencies as we are oftentimes asked to do in providing information that would help in making decisions and inform decisions so that will be a bill that that will also be filed and We have that bill that sin of also being it's in draft form of is with a potential sponsor and but it has not been filed as of yet. So Mister chairman I'm open any questions or will provide more information is needed. Thank you know if Jody a vice chairperson did you have a comment question at a just maybe thought you might expand on yesterday the governor announced the ready for life of new website in program that to coordination between education and workforce you need tell us a little bit about that and how that will coordinate with education and how that might improve facilitating people working. I would love to but I did not bring my notes on that and our role in that is providing the software that will be utilized for a providing the funding for that so I'm sorry I will I cannot speak to that I could. I could go back review my notes and then speak to that but I can't right off the cuff hopefully it will be my problems always been the silos that we create without much coordination between all the departments of also I wanted to thank you you've been very responsive Thomas unemployment problems with constituents I think we all feel that way but thank you thank you thank you and and back to the to the the work force program that you referred to earlier there are yes did numerous departments that are participating we're all coordinating and working together on that that is there are employment assistance division and so I apologize for not having more information about I'm afraid I would mistake so I would I would prefer to bring that to you the next time I before the committee if possible. Thank you. And committee members those of you that are new all of the questions you get about unemployment and pandemic unemployment cares funds and all that related to unemployment goes through the official US department and the U. of done a good job very good job under difficult very difficult situation and we appreciate that. Thank you very much thank you represent live in thank you thank you members of the committee. All right the next department that we had listed was the department of energy and environment. And unfortunately none of them could be here they have a call with related issue I'm not sure what it is someone going to that but but they were not able to make it today but secretary Kellogg always mispronounce her name but would have been here but just for the new members A lot the maybe all of the eighty two the only the Department of are no quality of bills will come to this committee things related to environmental or water waste landfills of those kind of things so that department will be bringing a number of those bills to us. All right. All right that's all we had on the agenda and since it was a blank agendas one hole to an hour or so we went little over that so again I want to welcome everybody I'm looking forward to the committee in the work that we're gonna be doing this session so thank you all for being here. We are. yeah pick up your trash one thing I want to tell you all if you didn't know this there's two entrances you can come in on the side which some bill came in on