Public Health, Welfare and Labor- Senate & House

Members if you'll just find your seats for going to get started here okay we'll all right we're gonna go ahead and get started. A call the meeting to order and thank you everyone for attending the this joint committee on public health welfare and labor and. My comments are you know we're excited about and. Things that are on the horizon the vaccine that's on the horizon and I hope that's gonna be a game changer for a lot of folks and so I'm glad to have a look for to that discussion with the Arkansas department of health and and the status of covered nineteen and in Arkansas and appreciate them being here and we'll get to them directly I know that doctor Romero has a meeting to attend so we will add get to him quickly and as for you know my further comments and I just want to thank the staff I want to thank Mister price it's been a wonderful pleasure to work with you and the staff that we have to be a large do an amazing job each and every time we have a committee member committee meeting and with legislation legislation that comes before this committee so it's been a pleasure working with you and members it's been a great pleasure working with all of you as well on the Senate and house side and being a part of this committee represent of Ladyman do you have any questions or comments. Yes just. If a man's coming up in my glasses service well I'd just like to say the same same thing that you said the Mister price it's been great working with you done a great job boards and I appreciate very much and the rest of the staff as well it's been we've been really busy probably busier than any other session with the Kobe and you all have had to react very quickly and I appreciate what's all done very much and also senator Irvin I know this is not our last meeting but you we have one more minute I didn't want to. Let this pass by without saying how much I appreciate working with you and the the partnership that we've had in a I think we've really got a lot done because we work together so I appreciate what you've done chairing the committee for the Senate thank you Representative Ladyman eyes this sentiment so the same you've been an honorable and gracious and wonderful man to work with and share this committee with ins and the state of Arkansas's blessed and we have we've done a lot of work and will continue to do some work and we've got some legislation I think pending for the session together so I look for to continue to work with you on those and and and she's an and I appreciate your kind words I am I agree we've we've done a lot of great work on the committee for the people of Arkansas and before we call at the and Senate by Representative Johnson his daughter has the dance recital to and he needs to get to that dance recital because I was a former dancer and so that's really really important that Daddy be there for his daughter's dance recital so members I'm just gonna go quickly and he has exhibit eight seven exhibit eight six I'm just gonna let him a present and H.. And nine I believe do you want to do all those real quickly just we miss me too adopts. His I. S. P.'s. And I'll entertain a motion to do that just where your eyes find represent a Boyd you're recognized make a motion. You're recognized thank you madam chair I make a motion to adopt all three of those eyes speaks all right is there a second. Second all those in favor say aye. And opposed ayes have it those I if peas are adopted thank you all right with that we're going to move on to doctor Romero and if you will come up. Good afternoon center Representative before being let me also state that it's been a pleasure working with you both over this last session this is the first time I've ever had interactions with the legislature and I want to say that it has been difficult at times but it's been all the time all the more easy because of you too so thank you again thank you for that we appreciate that very much it's been a pleasure working with you as well. Am and with that we will proceed if you'll give us an update and then we'll take a short time to answer any questions so I I heard that you mention vaccine in particular let me begin with that and then I will going to whatever topics you feel that are important so as it stands today. vaccine will go before the FDA on the tenth of this month four are you a authorization this is not approval it's authorization. The it appears that it will be Fizer is a vaccine other vaccine is a novel vaccine never before come to public A use it's in our in a vaccine it has shown at least in the preliminary data that I've seen it is very preliminary data that it is very efficacious night greater than ninety percent and preventing disease and has a minimal profile of of of safety concerns it is re at what we call reacted genic which means that it causes some fever and swelling and pain at the injection site that is not necessarily a bad thing. we we are have not seen the the full appears efficacy data that is we meeting the ACIP has not seen the full up because he data and safety data but hope to see that in the coming days tomorrow there will be a meeting of the A. C. I. P. vote and that will be a an interim vote on the use of the vaccine itself to the ACA PS stated of. Several months ago that it would not issue a final vote until the drug until the vaccine was authorized by the FDA so keeping with that but understanding that at the end of this week by Friday every state and jurisdiction must have locked in their distribution of a vaccine for the upcoming releasing all talk about that in a minute we act a match and talked about offering guidance for the use of what we believe are the first group or for sub tier within Group One of for the general for the for the the administration's to use this way they can make a decision of where they want to do with what the vaccine to go on that will be done tomorrow we're meeting today have a work group and you were kind enough to let me leave as soon as possible to attend that workgroup meeting so tomorrow they'll be that boat there will be another vote somewhere down the line usually occurs forty eight hours after the FDA's vote where where the ACIP will approve. The vaccine. If the vaccine is shown to be efficacious and safe so. With a background in mind let me say the following throughout this whole process that is this works speed that of the name has been chosen this is a. Private federal partnership that has allowed FOR xcelerated development of vaccine that acceleration is built on part in part on knowledge that we have about these viruses and the development of two previous vaccines and never need to come to market. That had either a limited pandemics or or outbreaks in and geographic areas that allow the the scientists to develop vaccines much more rapidly and to undergo clinical trials. So throughout the clinical trials both on the part of the pharmaceutical industry on a part of the FDA and are part of the safety of the CDC paramount for. Determining the the the the authorization the use of this section has been safety and I think it's very important for me to bring to you that understanding that safety will not be has not been compromised at any point during this process and that a vaccine that is approved by the FDA and approved by the CDC will be a vaccine that meets the same standards that we have had for any preventative infectious disease in the in the past. Furthermore in addition to the safety vigilant set has occurred during the three phases of trial there isn't there will be an ongoing for fees of safety my monitoring at which would be in if this were a normal commercial vaccine we would call this post marketing of vigilance this is a very robust set of three to four different institutions that will be following for rare safety signals so the public should know and you all should know that we are not going to turn this taxi loose on the public without further scrutiny and that post marketing or post approval licensure monitoring safety monitoring has in the past shown itself to be very effective so about two decades ago that surveillance system identified a problem with the vaccine use in children called rotavirus vaccine it identified cases of intussusception allow the FDA and to and the ACIP to pull the market for the vaccine off the market and re issue recommendations during the recent H. one N. one pandemic it it on section is pointing pending excuse me on it detected episodes of gamble race central and these are episodes of disease that occur only when you actually millions of individuals are extremely rare they occur we know that they can occur and we're Vaught were were monitoring so With regard to logistics a couple words and then out of turn it over to you to ask me questions we believe that the there will be a distribution of vaccine within forty eight twenty four to forty eight hours after the FDA gives approval that means that we think we will have vaccine in the state sometime at the end of next week or very beginning of the week after that. and then from there we have already Is submitted our will be submitting our priority institutions to receive the vaccine they were determined by formula that took into account of the number of health care providers within the institution and the number of covert cases they care for and using that they came up with a formula the vaccine we will be receiving will be the distributed to us from the federal government on a per capita basis so it is determined as as to how many people are in the state as you know three million and change so we will be receiving a survey about it will not be probably enough to cover everyone. Hi and we will be continuing to receive rollouts periodically three weeks or so after that. Lastly you may have heard that Madura another are in a vaccine that does not suffer from the same restrictions of cold storage that Fizer vaccine has a will go before the FDA sometime towards the end of the month we I remember correctly it was the dead December twenty first or something like that so again the FDA will be meeting on that ACIP will be meeting on it and we should have a roll out of that vaccine towards the end of this month also and stop there and answer any direct questions you have thank you very much toward the end of December yes ma'am. And okay quickly couple questions number one I just wanna say operation warp speed was or has been incredible to watch and I'd I just I think it's real clear and there cemex missed messages in the media about the safety of the vaccine because it was under the trump administration and I just want to publicly state I think that's incredibly unfair for the media or for anybody to state that and president trump and his administration did an incredible job in my opinion with operation warp speed in collaborating with the scientists and the private industry and the partnerships that occurred to simultaneously create this tax and vaccination and vaccines you know and mass produce them at the same time and take that huge risk but if it hadn't been for those actions and the administration we wouldn't be here right now because I'd I'd I just think that's really really important and it's not that message about that accomplishments for president trump and his administration is not out there clearly enough and I think it needs to be recognized by not just this body but by our entire governments in the country because I'm I'm getting frustrated you know hearing different things and people also then because you know of who is in the White House. They saying that it's unsafe and not to take it or or whatever so I appreciate the fact that you talked about the safety and the vigilance that is been undertaken to make sure that it's a safe vaccine quickly a couple questions and the current laws in this just because I think I and other legislators are getting emails we are now we have no plans to change our current laws about vaccinations is that correct that is correct okay so we can dispel any of the fears or anxieties if people don't want to take the vaccination or not foreseen the vaccination on anyone is that correct. That is correct we have we are not mandating the vaccine if that if that is the question that right so current state law does not mandate that we've acts vaccinate people or provide immunizations for people there are some exceptions in that current statute and said there is no plans to change that that is correct at this time okay and then did you talked about the different Group One that different distribution. So our veterans how are they are they AT then to go to the veterans hospital or is there a different distribution for veterans verses hospital and employees I just wanted to know that one because I had some questions from veterans about the vaccine and the distribution to them yes ma'am so so veterans that are. Not in active service are considered civilians and they are covered by the ACIP recommendations a different lot a vaccine has been set aside for the military and they will take care of their own. Out of duty yes yes ma'am okay veterans will fall under the tears so let me take a minute to talk about the tears and and and how we are at today so within the phase one we have we the ACIP maybe I should just say C. I. P. from now a CIP has has subdivided that into four basic groups they are the healthcare provider's writ large and I was been a minute talking about that it's not just the doctors the nurses respiratory therapists it includes and it is the the the the the the express point of the ACIP that includes house keeping the lid persons that keep that institution running it it the the the the person that deliver the food anybody who's potentially exposed and that is for equity reasons right because we know that there's a significant proportion of of minority individuals employed in those in those areas in addition there's also now than the other group which is under discussion and vote which is the residents of long term care facilities in the United States there have been roughly five hundred thousand cases of the total cases of covert that involved Individuals living in long term care facilities but to specifically nursing homes seventy thousand deaths in that group. Then that's why they're in that group. The next group are the essential workers and essential workers including compass a large body of individuals we to the the ACIP did not make the groups that fall under that that falls under C. so there's two the there's two sisters in the in in in the in the federal government this is the one that that is for work and so it has determined which of the priority groups but for example it includes the main operators of our nuclear plant the main operators of of of our of our looking at electrical system it's not for everybody there's a select group but it also includes individuals that prepare our food so those men and women that are involved in food processing. Poultry plants those men and women that are in the agricultural industry there are important postal workers are important so there's a whole group of individuals in that essential worker. The next group would be those individuals over sixty five years of age so we I. Within that group have now entered a high risk group the mortality and morbidity is higher in in in in the older you are so there in that group and then final group in that first tier would include individuals that have co morbidities so we know that obesity diabetes hypertension things like that increase your risk of morbidity mortality. And that's how that is has has been developed there's now then after that the general public. Okay and so is there a message I think you know those folks that don't fall into these categories just be patient and know that you're healthy you're in you're not as at risk of some of these other people or what is your message to the people that may not be and Group One I think you've stated the very well center that is patience we will have vaccine for everyone that's willing to that wants to take it. I believe okay at a that we will have this this large enough amounts of vaccine available for the general public middle of next year. Okay alright thank you represented Ladyman. Yeah just just one question on so I think I heard you say well we are allocated three million vaccines. Is this correct. Sir we we don't we will we will eventually receive enough vaccine to to vaccinate our population of three point one eight million or whatever we are at this time but but our initial our initial allotment will be far less than that and and so. We have been told it to to plan on somewhere around twenty five thousand does. Okay the first that that I will first and and and that will not be enough to cover all the healthcare personnel on the first go round we will probably need to wait until the second allotment of vaccine to be to to begin to cover them. So do you have any idea on the time line like first and second I mean is there do you know what that gaps going to be what we would be me the the the between the one a one P. one C. the that that group or that or the different allotments different allotments we think that's going to be about two to three weeks four weeks in between that will give us enough time to immunize individuals the current vaccine Fizer vaccine which we think is going to come out requires a second dose so remember that it's not one dosage two doses and that has to be given four weeks after twenty eight days after the first so so at it you know the different states are doing different ways some some states are are saying that in speaking to Mike my counterparts in other states some places are going to go and immunize everybody across the board other people are gonna say we're just going to focus on this you know getting a certain Qadri of individuals immunize fully and then moving on to the next group so it varies you will probably see many variations on how to do this as long as it's within the the framework. So the first three vaccines that are approved that are coming all take two shots during a takes to. I believe the third one takes to I will I will I believe well so let me go back here it so AstraZeneca was a hi a top runner in this as you know there was a miscalculation in the in the quantity of the antigen in the shot that means that the data the presented is not fully valid they have had to go back and re initiate their clinical trials so they have prolonged their submission and it but that's much to our chagrin but those things happen and so they will not be coming up right away they that vaccine I believe is a single dose and and and we were really looking forward to that but it will be late I see no reason why we it will be successful when is re it evaluated after completing this the the prolong start of the additional studies okay next question you may not be able to answer this but okay he is going to be two shots basically a month apart so how is your department or are you going to do this track this I mean to know you know people may not come back I mean is there a method to track this and then also in addition to that you know how are we going to know that in the public what you're we're protected I mean is there any kind of is business going to be opened the first month or I mean what what's the thinking on that okay so let me let me answer the first question how are we going to track so we have a very robust vaccine registry here in the state long before this started and that's a bit backs in registry we have use for our children I'm and we can use that we it's being used for adults that will be the backbone of our registration so everybody who received the vaccine their name will be entered into this registry at the same time the individual would be provided with the card which has the name of the vaccine that they receive because the vaccines are not interchangeable and when they need to come back for their second does we. We will follow these individuals and see that they have their second does send out reminders again this is you know we can't force somebody to have a vaccine all we can do is remind them that they're doses do and have them come and get that so your second questions represent I'm sorry was a. What I'm wondering I mean what's the plan we when we. Yes the opening of this of of the economy is that yes yes okay so it's important to keep in mind that that We will not have enough individuals vaccinated until. We open up the general public that is why the mines by the myself and I concern myself not very bright I have already said that we are going to be wearing our masks we're gonna be using as a social distancing on washing our hands well into next year I'm and I foresee that happening at least until the middle to three quarters of next year before we have enough people fully vaccinated in order to say we can begin the return somewhat to normal. So it's going to be based on monitoring the results and how fast the distribution is I mean you know what AT and uptake Sir so so as as we say you know it does no good to have a vaccine if they can't get into your arm and if the public has reservations about this vaccine the and and and has reduced uptake that could be a problem that that's one reason why I have stressed over and over again that as far as we see today and as I have and it looked at this is a safe vaccine. Thank you. And how many are in the at and to spend in that first group how many people even the in the healthcare provider group is that the so Arkansas yes let me see if I can give you that number it is substantial on. So I'll give you the numbers that I haven't and you all can do the math full time part time hospital staffing six though sixty six thousand one hundred forty two individuals. Inpatient healthcare providers. Fifty eight thousand four hundred and twenty. Healthcare providers in long term care facilities. Thirty one thousand nine hundred. Outpatient home health care providers fifty seven thousand. Nine hundred and sixty. Emergency medical personnel four thousand two hundred and fifty. Okay and that's just not first group at that that isn't that is our health care providers. Hello overarching yes got to okay and then before we move to other questions quickly I read the reports every morning so I and I see you know the number of beds that are available an icy use some patients and I and then later some may I think we're we're good there are me were what we have reached a high numbers but we're still maintaining the ability to care for those individuals that might be and I see you in the hospitals are ventilators sat correct so you you are correct we have we we are getting towards the top of our priority but is important right remember I'm sure you're seeing the numbers that it not only I mean when they say we have ninety percent of the. The feeling of of our ice you is only twenty percent of that is because of it correct right so so we're not feeling our hospitals with cove it right with other things so yes if we can decompress by moving those bills individuals out those non cove individuals out we can have a space the our biggest problem which I'm sure you know and and and everyone in this room knows it's not it's not the space is the staffing right because what happened in the in the spring was that the major epicenters four four outbreaks were New York New Orleans places like that and they were healthcare providers it could go out to those areas and provide health care even though they were not from New York in the state now everybody has a upsurge and so we don't have that ability to to bring in people and if I may add one thing here I I'm sorry at a to say this but I think you all have to have a realistic view of what's going to happen the next few weeks we are about to enter a search upon a search. unfortunately our population has not and that is a population United States. Has not heeded the warning about the up possible risk of infection and travel and holiday season. I'm and we have seen is much travel as much travel nearly as much trouble as we did last year this year and that is a harbinger of. Possible search and we get that we have yet to enter Christmas and new years you. Well I mean I think fairly to say yes there but there's a lot of other things that never get mentions as to why I think we're in an up tick as well large mass gatherings you know in the public where nobody was wearing masks and people tend to not talk about those things that they want to talk about the things that are easier to talk about like thanksgiving and Christmas and I'm not be and disrespectful at all I'm just saying we got to talk about all the gallery and you know at equally and fairly but you I understand that I think that's a good you know segue into questions my concern is the and there's just people take that that since snippets and say I'll work at capacity and you know we don't have I mean and not that fear doesn't help people he no we are hospitals do have plans and they are and have been under these plans since March they know how to shift they know how to create more I see you in code ward beds if they need to you and they have those plans in place and so some hospitals are having to an act that others are not it's just depending on king at the cases around the state from what I see but I just it's easy to pull those things out and make people really scared about you know our hospital capacity and our ability to take care of patients may I hear you we we will probably see a search but I just wanna make sure folks understand we're doing what we're supposed to be doing as far as our hospitals in our health care workers we do have a plan and is is I said we twenty twenty twenty percent of the I. see you better are occupied we still haven't reserve ventilation with mentally reserve but. We are concerned and I'm watching this very carefully yes and and we should be and I appreciate that Representative Bentley. Thank you chairman thank you doctor member being here today this quick response I was looking at a letter from John Hopkins about the death rates in the United States is surprising to see that really haven't sent increase the death rates in our nation we have seen increased did cover but we have sent decrease in heart disease. Report is heart disease restoring all that have you seen and Arkansas's when I would seen an increase in deaths in Arkansas this year last year do you know I think we've seen an increase but the numbers I wasn't prepared to talk about but we are seeing increased number of this I just that your response to that to you the thing that we have maybe missed reporter some of the things that they were heart disease or respiratory that disease and I've been able to scope it across the nation one looking at this report no I think that the the the designation of a death as cove it has to do with the finding of coverage. I know some of code in that patient and that can be either definitive that is by PC are antigen or probable and our recommend our listing of deaths as covert for within the CDC's in the in the CST ease a definition of a covert related death. So you don't see any any strange when you look at this report and see a drastic decrease in heart disease does to the heart disease or respiratory disease on it does does not bring question to your mind at all when you look at that center as of a represent Bentley I have not seen the report I would need to see that report before I comment but I would need to look at it so okay that's fair enough can you tell me were at Arkansas right now as far as the percentage of patients they get on the been later that recover in those that do not fried coated COPD patients and we're at forty three percent one time you know we're at right now no I don't know what with where we are on that but roughly across the country if we look at everybody it's fifty percent so it it is not it is not a good indicator about come. Okay and lastly chairman I appreciate your indulgence on this is a report that came out showing of recently just came out this week another report has not been published yet but talking about an eighty four percent of your hospitalization for patients that were treated with eyedrops or core Quinn's ink and a return was not over the mice in general every comments on that it came out yes I did look at that report that report is a retrospective report has only one hundred forty patients their number of flaws which we can the the findings among them are the mixing of criteria for determination whether they have a covered or not it was published in the journal that it would not be considered one of the top notch journals in infectious diseases but without getting further into the weeds there are flaws in that. In one along with that in the last two weeks there being at least three reports published in the New England journal of medicine and journal of the American medical association that again show no benefit to the use of hydrogen court one. One last comment chairman thank you Adam and I would just say that we all over in mass because of the hundred and forty people that want to see a hairdresser didn't get cove and so I I wouldn't discredit the number of a hundred and forty I just I'm very disappointed that we have not taken care of this is my my statement chairman that would not taking care of our long population in the state as well as with as I think that we could have of them could have done a number of things including this allowing of patients and doctors to do what they thought was best for the patients and I wish we have that follow what they did in the great Barrington decoration and taking care of all population the state I think we've seen this in our adult in our our seniors that would not obscene if we had fall that I just want to make that comment this point that I'm very I'm very disappointed how we've handled things in this state so thank you chairman thank you doctor merit if you can switch to a different Mike it has the cover on it so you don't get that feedback just a yeah has the and and I'll let you may I have for comment then on that. So we are not wearing mask because of a hundred forty three individuals I got exposed to a hairdresser we are one mass because there is overwhelming data to suggest that wearing a mask limits a transmission protects us also so the mask issue is not related to that report is related to many other reports and information we have that scientifically shows that the it is a benefit in the prevention of transmission. One quick question I have for and I know one of the things we have a trauma system and a call system and I know that I read in the comments of doctor Patterson I guess on the winter advisory group talked about utilizing that for Kobe patience I actually have been saying that from day one and that that we need to you know utilize that trauma call system for not just trauma patients but Covin transfers to making sure that we get quick transfers also in my opinion for mental health and making sure because bed bed availability is always at the hard part for that but if you don't mind just talking about that possibility perhaps and the last thing is and the Arkansas health care association sent me a they worked with the Arkansas hospital association on a long term care transfer help desk in transfer assistance hotline which kind of talks about this as well so appreciate their efforts and I appreciate the healthcare association of the hospital association creating this LCC transfer help desk and and hotline so I can share all share that with the members of this committee and the legislature as well but if you could just talk about quickly does two things for me so I I can talk about trying to calm is that is that yes yes trying to calm has been looked at it is a goal we we have determine the cost involved and I I believe we are just about ready to go for with this is the system is is well I had the opportunity of of touring their facilities the dispatch I'm I think it is an outstanding outstanding asset to our state and and then like I said thank you for that and then like I said I'll send this to Mister price and he can send this out to the members of the committee about the long term care transfer help desk that they have set up. So often that out too okay thank you Senator hammer you're recognized for a question thank the manager a doctor where you made a comment will go on to get some clarification on it was regarding the vaccine and when it comes down to the state may be a mis heard your I want to clarify did you say something about we were going to do something with regards to verifying the quality of the vaccine this coming down or we were going to of tests that are self for can you clarify that comment please no Sir and yes Sir I can what Coker find to to. The we are not doing any validation of the vaccine that is done four four for safety that is done by the FDA and the ACIP there are states that have stood up their own it buys records I don't see that necessary the federal government has us to have the FDA's invites reward which is a four pack I served on the for packing was chairman of the repec the quality of the individual's extreme myself if you will were outstanding and they are experts in their field I sit on the ACIP and the chairman of the ACIP and they are not standing group of experts and backs and all okay so once the vaccine it's the state it's it's gonna be directly of made available without any filtering on our part when she gets in the state is that correct that is what I that is my knowledge I I have not heard from the governor who would make this decision otherwise okay in on the number of hospitalizations that are reported daily does that what what qualifies a hospitalization do they actually have to be admitted to the hospital or if the present in the E. R. and is determined that they have co within maybe they're only in the E. R. sixteen eighteen hours is that counted as a hospitalization. No Sir not not to my knowledge but I can get you a definitive answer on that my understanding is that all hospice all individuals listed as hospitalizations are individuals that are occupying a bit in hospital have been admitted but I can have my staff answer that question conclusively for okay alright thank you thank you Sir yep thank you you can just send that to us and we'll send it out to the members of the committee the Representative Sullivan you're recognized for a question. Thank you madam chair Dr Mary I'm on the other side over here on the active side yes Sir. First of all you know about a month ago your department was very critical of northeast Arkansas for despite that we had Capp targeting leadership in northeast Arkansas as being partly responsible and your when I ask for data to support that I was not given any data that we weren't wearing masks better or worse than anywhere else now the last two weeks they came up and did a an investigation in northeast Arkansas and of all of our restaurants and all of our stores none was found to be in violation so first of all I'd like to make that point that when you're critical of our district in my district the people I represent I expect to see the facts in the data that support that. As a question on. Can we put out a lot of information on you know where to go but churches what was the appropriate guidance what was appropriate Guynes we put out a lot on a lot of the different things one thing I never saw was FOR the department of health asking people to afford Black Friday and not to go shopping at stores and congregating with people it just seems like to the people that I represent that there's a very targeted approach to what we're doing for example targeting restaurants closing after eleven I'd like to see the data that supports that will make a difference and also like you to comment on my my observation that we seem to be targeting certain industries while leaving others alone could you respond to that please. I believe we're not targeting anybody is best specifically we're making recommendations that apply to the general population and and that is sites and where you congregate where people congregate where we have seen increases in the number of cases we're measuring recommendations eight women so the record there's a recommendation to close at eleven. There is a curfew to close eleven is there not a recommendation as a it's a curfew. That's not a recommendation you there's a penalty applied to that correct that is correct okay so do you have the data that supports that will make a significant difference there are need I think in another state I could we could get for you okay thank you thank you madam chair alright thank you I'm going to get a Representative Payton and then represent a Ferguson. Thank you madam chair Dr Meryl math questions real simple everyday when we see the report he got such a certain number of confirmed cases in a certain number of likely cases and so the following day do those likely cases from the day before become confirmed and and therefore we kinda considering on twice because I never see a a list of the likely cases that were not cases right so we we separate them into two categories. That is. Firm cases and probable cases the confirm cases for our confirm because they are PCR positive. Probable cases our problem because of the antigen testing is done and they can also be clinically related. it is possible for a probable case to become a confirmed case by either a report of a PC are tested follow the antigen test when that happens that individual is moved to the confirmed okay and removed from the probable so they are not double counted and we do that accounting because the every day before release the list so the those numbers that you see has probable and confirmed fall into those categories on that day. Also bear in mind that the list that you see that we report is always behind because there is back fill of those days so for example attested conform today for PC this reported those performed today if it's were done by the P. by the health department we will probably have the result today but if it's done by another lab a commercial that it will be reported for three days so that number will be added to today's total even though it's not reported today if the bill so when we're talking about the number reported it's not number of cases it's number of positive test the. That would be considered a case. Well I mean I have a friend last week was tested for times within a two and a half days. So did that get reported is for cases no one case no Sir it's counted per individual. Okay. Thank you thank you madam chair thank you Sir yes a Representative Ferguson. Thank you madam chair I'm trying to understand the distribution a little bit so we get twenty thousand does that really is ten thousand buses if if you have to get to Dallas is so will you give ten thousand a reserve the other for three four weeks later we get twenty thousand and hope you get enough light. Thank you for that question that and now what we will do is we will give the twenty thousand take the next allotment and re vaccinate those individuals and give them their second booster dose so we will use it in that manner the vaccine has a certain storage requirements that may or may not be met depending on the institution so I'm it is to get a little bit into the weeds here. It'll it'll be they will be sent to us in our trays and are on a dry ice that container can be re charged two times so it can be stored for fifteen days if you have a minus seventy degree or greater or less this temperature a freezer you can store it for longer than that and so that is why at least in our estimation we're going to go ahead and vaccinate everybody take the next Alachua given their booster dose and then it will be done with. Okay thank and I just wanna say thank you to I can imagine how stressful this is PM in dealing with all the misinformation and it reminds me of that quote you're entitled to your opinion but not your own set of facts that thank you all for bringing scientific data and information thank you welcome thank you members I just and one is re iterate that the long term nursing homes they do have beds available and Because of space add just some people may not be able to get their first choice initially living leaving the hospital because of space but they're trying to help clear out space at hospitals expressly with elderly patients so that you know to try to help with the flow and and the space issues so again you know I've sent that to Mister price he'll send you that memo but I think it's just an important tool F. for people to use and if you get contacted by a constituent that may have somebody his elderly or is being discharged from the hospital that might need to space to go to in a long term facility that you could also utilize this option so just wanna make sure that we're all up to speed on all the information that's out there and if we need to call another meeting at the end of December to get an update on vaccinations that have come in we reserve the right to do that the committee so number fifty nine I believe that is Senator mark Johnson if you're recognized Sir. Thank you madam chair of Dr Meryl I would go back to the the actual vaccines in the the at least the three were hearing about have a family member who was involved in the maternity trial you a mess and she got the right one she didn't get the placebo the tower her arm swelled up she had a Fever for awhile and he did the follow up and she recently had an antibody test and didn't show the level of antibodies I think that we're expected is that. The issue be in is she not amended she need to get the Fizer vaccine to me what I and I know that we're grateful for the speed that that everyone from the president on down has done to get this done quickly on the other hand. At this point we need to know what works and what might need to be adjusted or just like any dose of any medication D. can you comment on on house where I am with this family member and where we are collectively people in similar situations Sir so first of all let me the thank your family member and and he or she is a true hero because they have volunteered to receive these vaccines so that others can benefit from them so thank you very very much thank thank thank him for on my part I will Sir thank you up to your question is a good one Sir at we know that within the the study populations and and I've seen some of the preliminary data with regard to antibodies that there are individuals that will respond appropriately to the vaccine with high titres I'm and there are others that don't that that is always the case so without knowing specifics about the individual sex age and underlying conditions. I think that at this point we can't be certain that she is immune or not immune in other words we don't we can't offer any advice about whether she should resources should forgive me he or she should receive an additional dose those are questions I think that that we will that is the ACIP in the FDA will need to address in the future I'm. It is possible and I have no idea would it would it be indicated for her to receive another booster dose of the maturing of accede to see if she can to stop or he's here she can because stop so I don't know Sir I I I think those are the unknowns that we have at this time certainly there will be a certain population a certain number of individuals that receive the vaccine that don't get a an immune response to as high a level as we would like but they may still be protected is to the best of your knowledge and I'm not pending the dental knowing all this but I to use the word mix and match but if if someone receive the backside the maturing of axing then would they be would it be appropriate for them to receive Fizer one of the other of AstraZeneca course is another one that seems to be in the mix but the I assume they're not interchangeable per se could you comment on that so you are correct the vaccines are not interchangeable so if you start with one you must finish with one I'm so whether you can be boosted by another vaccine is still up in the air we have no down on that at this time okay great thank you very much doctor mayor thank you madam chair thank you for your presence. An. Representative the. Thank you madam chair Dr Meryl I'm over here there's a video going around that has. In somewhat of a concern with several constituents up in my area of the Jonesborough. And it relates to the AstraZeneca covert nineteen vaccine and I've read reports where they've been testing it possibly in India with not. The best results that they would hope less than seventy five percent I guess the word is efficacy or whatever but. On the package the person presenting this. Little video clip says that. It's made with human fetal tissue and so I would like to be able to respond to people in my area. With just some fax and so if you could address whether or not the Colbert nineteen vaccines whether it be from Fizer. Or from a darn a and a AstraZeneca. Our. Including human fetal tissue I'd appreciate that so it is I would I can get you the the the constituents of the vaccines and I think that's probably the best way to do it when I can tell you right now is these do not use human fetal tissue so the at and make a more explicit. Right of war this is are not used to prove to prove to prove it to prepare this vaccine and ours the products of an abortion is not used for the preparation of this fax. No babies are aborted in order to get this vaccine at this time. Let that really helps me know how to respond to. I thank all of this probably get instant Messager. Messages like daily with different things and it's just. Work in and dated with information whether it's factual or or a faulty but I appreciate your response to that thank you die I will get you specific information as to when cell lines were used to create that but but but my answer stance that no baby was aborted to get to create this lot right now okay thank you madam chair thank you no problem thank you of represent Bentley is not here but and she's coming back Senator hammer I think this is the last question thank you Mr chair With regard to the vaccines was there any change as far as a going to the big box stores for distribution or we had a conversation about a month ago in and asked about independent pharmacies to have the refrigeration capabilities to store what was the final results of that independent pharmacies that have the capacity to store a vaccine will receive it they will be part of our vaccine allotment program and doctor delay can tell you more about that if you need information we can get it to you well as long as I know that they're in the loop that's the main that they are and and pharmacists to both the big boxes you said at but smaller pharmacies will also be important in distributing this vaccine throughout the state will they be on the initial distribution numbers that can be handled because of the target audience is going to receive it or I I I believe it's better if I not answer that question because I'm gonna give you I don't have a hundred percent. But at this point so I think I think it's unlikely but okay and then the second thing is can you give us an update on the contact tracers because I know that we appropriated a certain amount there's some questions about the job is being done in which which is kind of give us an update on the contact tracers yes so we are adding contact research to the number we already have We are trying to keep up with the number of of cases with the growing number there will be strain on the system along those lines I I should mention that there is some talk within the CDC that recommendations for contact racing in contact visitation maybe change the next week or so so we'll be looking into that is as I comes down the right now we have we believe we have sufficient contact research to deal with the current surge in cases and can add more if necessary are you at liberty at this time to talk about what those changes might be years and in the development and during development Sir I don't have the the the actual discussions and from me I for this through the grapevine okay and then the last thing is this on the I'm trying to member on the reporting of the numbers. I can remember do you report the number of negative cases we get to positive we get the pending I can't member on the negative cases the report that so for antigen testing Sir both positive and negative are are listed for for PC are we list the positives and we have the negative also available as but I'm not sure if it goes out to the public I see those every day so I know that they're there would that have any bearing on the perception of the public if they knew the total number of negative cases also because it seems like all we ever hear about are the positives in the pending and if we had the you know for the for the thousands of tests are being given a thing would be a good piece of information to allow what the negative test or they're coming back to be included in that information we can talk we can talk about doing that the other thing I think the public can use this is what we call the percent positivity so so there is a fourteen day rolling average of positivity that tells you the percentage of tests were positive in that in that period of time that we're looking at that's particularly useful because it will tell you you know it will give you the exact number of negative it'll tell you how many of those were of those tests were positive we can talk about possibly getting the the total number of tests performed each or reported each day out or thank you thank you Mr. One last question for you leave thank you for saying hear an answer and the questions will doctors and their clinics be able to give vaccines to their patients I believe so we have a number of of clinics have already in doctors have already signed up to be vaccinated is for this for these viruses for these vaccines that come forward so yes and the person that that we would contact would be doctor del Hey our state epidemiologist in the other person is spearheading this effort okay I'll all contact with her because I would like to know exactly how and I think it's important that you know they have as many opportunities to distribute and administer vaccines as possible and people are comfortable with where they can get that done what about our health unit center located in all of our counties will the health the public health units our guests are health thank you know your stone county health unit still be able to yes they will back things as well yes they will so as of this morning I believe we had over five hundred it clinics practice it's a truck that that had signed up to be VAX this and this and and everyone of our local health units will be as a distribution site for vaccine okay CS have like a one pager or one or two pager that she consent will send that out I will indeed helpful that might be helpful to go for it all right there no other questions thank you so much for being here and for your work and FOR answer the questions and as always we you know we're here in case we need to add to have an outlet to get information out to the public thank you thank you in a you mention that at the end of the month do you would you may need another briefing I would be happy to return thanks for saying that thank you it just you know we want to make sure that we get good information out to people and that they know what to do and and if the vaccine helps us at the beginning of next week I can imagine we might get a flood of questions and and and concerns and so I just recall I just. I preserve that opportunity to do that in case we need to of course senator thank always I much appreciate it very much okay thank you with that I know you have meetings to get to an votes to take so thank you for that work that you're doing nationally on the committee as well. I am okay and Anita and consideration to adopt the minutes from November ninth. Met so moved as their second second those in favor say aye opposed ayes have it the minutes are adopted all right at this time I want to bring up Paul Kratz. invents Schellenberg. They are small restaurant owners and I appreciate them being here as they come up I want to thank the Arkansas hospitality association for providing these to restaurant owners for us today to discuss this important issue from their perspective so thank you for being here and sorties balls of then one of my faith. As have I have been here a long time I grow grew up here in little rock and so it's been here for a very very long time I appreciate the business and I haven't met the all aboard yet that look forward to going to that scene so if you will both state your name for the record and you may make your statements and then we will proceed with questions. Then Shellenberger with all board restaurant and grill. I'm Chris with Shorty Smalls restaurants great thank you both for being here. You may proceed. The first few moments ago it. So Mr back March. A hard to top this may be a little bit on the side. I've been a business on the corner run impairment shack for for forty years if you're six feet apart from each other then you can take your math I mean you can remove it to speak if that helps you. So for forty years at that point and We learned that a lot in that time. this is the most incredible incredible pivot. That I think I've ever had in my lifetime. I want to first off thank the legislature and Madam chair I hope I got that right. Of for all the work that the the state is done in addition to the federal government I mean were an application right now for the new big financing or grant possibility. We did do the ETC grant. What hit me the hardest was what am I going to do about my employees. Excuse me. You know I don't want them to get sick either so a. But a couple stance about the industry as a whole which would probably a lot of people have heard you know there's over million locations in a stage and we are one of those that I don't I know northwest Arkansas on everybody else feels like we get picked on there's no doubt I mean restaurants inside then use and that's where the stuff just seems to spread. So with eight hundred ninety nine billion dollars with the annual revenue between ninety to ninety five percent of that is sent back into the economy. Where we pay. Landlord's we pay food suppliers knife sharpeners people that supplies linens on and on and on so the impact in addition to the fifteen million jobs that we have issues a thanks there's been some numbers run that we may be the second largest impact on jobs in the country and some four hundred thousand locations may never reopen if this continues now we've gotten a lot of help personally through the PPP loans it can always development disaster loan I got one of those and the ETC loan I got one of those. So what we do with our ET see money as we kind of figured out that there might be some problem with air circulation because people could pick up to go and I couldn't do it inside eating so we had a bird black companies install I wave air purification systems in each one of our seven intake air ducts in the restaurants along with UV lights and high density filtration we call that scrubbing the heir at this and data around it I'm not telling you that it. Cleans covered but we think we've got. Ccleaner circulated air inside and other restaurants or it other facilities period we see forty tables are problem is though the six foot this tension with a small building so I got fourteen tables open inside. we just put new outdoor seating and for the second time with heaters so we can see about sixteen seventeen tables. It's still such a fear factor for people to want to come into town line from all the stuff in the media. eight plus I want to make sure that we follow the guidelines that are set out by the state and everybody else so we do it right. But our sales figures. And I want to take a March nineteen to October we ran a million fifty one thousand roughly this year three hundred fifteen thousand or down seven hundred and thirty six thousand dollars in sales revenue and when you've got about four percent margin in this business. that's a seventy percent decrease our payroll in two thousand nineteen which impacts everybody in Arkansas three hundred sixty two thousand. This year a hundred and fifty nine thousand. Now are PPP loan we had to split between another restaurant had a different states under the same federal ID that restaurants since closed we had a hundred five thousand dollars with the PPP loners allocated to Arkansas. And this number that I'm giving you here of the Hundred fifty nine thousand eight all that up obviously when we have a hundred five thousand the ETC loan we put all of that and to the we spent about forty thousand screaming here so we've got about a month and a half two months left if we don't get some more systems we're gonna have to close our operations down basically We want to make sure that and and and probably most important to the state. is our tax revenue led in nineteen was ninety thousand dollars we paid and March to October we paid in thirty thousand this year it's a sixty eight thousand dollar loss to the state. From March to October just from one location that's huge impact to the state that's whatever does to the schools where where that money goes issue which. We had a problem when first opened our employees who will pull people are going to pay attention to the mask wearing they're not going to want to do that I get that I mean I know some people don't want to somebody to but we will we want defined by the ABC which you know or the health department so we implemented a program if you come to get Shorty Smalls we've got a telephone number you have to dial and it's a patented product and I've I'll make it available at. Close to cost if other people want to do it because I want to help the industry but when you dial that number to get a reservation is and he got a smartphone it will send you a form back to your phone and you have to certify what you're going to do if you're a committee with us and that's why you know the things are on the list on the health department what your temperature have you been around somebody you're gonna wear masks if you were in I'm asking your seated you can take it off when you're eating all those rules and they have to sign hat. And then at formada magically comes back to us and give them another telephone number and with a dial that number it shows up in the restaurant to certified customer so we've probably had almost three thousand of those forms filled out so the people know that when they come in with the expectation is so I think a lot of the stuff that happens is People are embarrassed when they show up and I don't have a mask maybe. Or they don't want to wear masks so they don't have to come that's fine I mean I. For thirty eight forty years my motto is been the answer's yes what's the question until pandemic it. Then the answer yes but you got to wear a mask because and I worry about my employees there were about my customers and I'm not can I get fined by the state for not doing the requirements so prescribing near an outdoor seating in the certification all of those things I don't know what else to do we're lost I may have gotten allocated to me out of the and I also got an emergency XP a loan that's alone have to pay back personally I mean I got to pay it. So we've gotten two hundred ninety three thousand dollars worth of assistance and loans. and I turned it on this bill a new big grand five hundred and fifty thousand dollars worth of receipts for things we've paid and we're not caught up on everybody so it's it's a losing proposition we've got margins there so slam and I think if the emergency that's going to happen in the country and it's my. Why forget a chuckle out of me saying this because she says don't pontificate too much from to that. But if we. Don't see something major happened we could have twenty thirty million people unemployed just because of the hospitality restaurant industry in this country. If four hundred thousand units never re open and the impact the ancillary impact is just impossible and we're not the only ones with the night clubs with the movie theaters were any place where people congregate inside and we're gonna learn to pay that we're doing some stuff on to go we've got some new technology I'm a I'm a patent guy I've got a patent pending on that thing where the house back. And we've got the capability now and some of you may have seen it you can scan a code on the table and picked up the menu. Well usually the scanning code or dial a number through the Patton but it brings the menu to your individual phone and you can place your order straight from the phone and it fires it to the kitchen you can re order and fires it to the kitchen and you can pay it from your phone and never and have a truly touched the system. That's in beta testing with this right now and it works quite well. and I'm I'm I'm hoping that we can get this thing under control but we're looking at a nine more months and To keep a restaurant open at run normally runs a million and a half we were gonna probably too close to two million this year we were really on a big up swing. At three or four five hundred thousand dollars a year is just and I solution like big numbers to people but and it's an incredible amount of loss that's happening so I appreciate what you guys are doing from the state thank you very much and with that. Commission questions I'll trade go ahead we want we want to hear from you and then we'll go to our questions. Yes thank you for for allowing us to be here and to kind of give you an update on what the infinite restaurants are going through amend like an employee with the details the as far as financial on me I think all independent operators are very similar what Paul pointed out we we struggled I've done the restaurant business for thirty four years and I turned I used to be the Bennigan's and steak and ale restaurants we pack a day and and and I just was a smart enough to do anything else like in the restaurant business but we you know we started all aboard restaurant which is a family or in a restaurant and we we took a a niche in the in this industry and took a shot at the St Louis to something that targets kids and families and You know in our business model is designed for we were trained to delivers your food to your table if you've never been all board so it's you know it's pretty cool it's contactless pre delivery but so you know we started in two thousand eleven and we have done be done well and we've actually and have two locations and little rock and in Denton but when code that has hit us we you know thanks at thirty four years doesn't mean anything when you come again something that you've never seen before and we've now found that you know I I feel with Paul we've had to reduce our staff from you know normally we're small fish in a big pond but we've. You know we we typically with with staff thirty eight to forty two people in the in the two restaurants and right now the last payroll which we just did last week we paid seventeen people so there's a lot of people it we we do hire a lot of first time workers a lot of people in high school and college their first jobs and and given the opportunity to get into the. And into the workforce and we do fear as far as with the mass requirements and with the joint to dealing with the general public that they are healthy and safe and we do require people were mass when they come in a restaurant but again we're not a drive through we solely response rely. On people coming into the restaurant and dining and with the office of the mandates being only open to be able to only open sixty seven percent your restaurant right now it's it's hurting us we you know like I said so a very Paul's numbers we've we've taken a great head we did. In the doctor earlier speak and saying that the you know of people are fearful and we we understand and we want to do our part as restaurant operators and be responsible but the as a business we've we've taken an enormous hit for being. And to the public We we we anticipate I guess with the vaccine that the most the general public will not receive the vaccine until the third quarter of next year that's gonna be hard for us between now and then to to build the confidence in back in the public to come back in and done in a restaurant so you know that that's a timetable I think you're gonna see a lot of independent operators small people like ourselves who were are are going to try to find another way to make a living because this and we we we to have taken the the PPV loans but they do not meet the the amount of money that we have actually sunk into a personally to try to maintain and stay up and stay afloat With that I hopefully with the vaccine and in the third quarter I don't think will recover any profits until the end of twenty twenty two. So thank you both for your testimony and for being here and it is I mean of great concern to me we see layoffs and hospitals and clinics and you know everywhere ms just it's really has been hard one of the I will I'm friends with people that and scallions and in little rock and they do a lot of catering and lot of private parties and normally December's one of their busiest month and they told me that normally it's around a hundred and seventy to two hundred different events and they had to scheduled for the month of December down from you know nearly two hundred which is a huge you know that strap dramatic So it just you know I I know one of the questions I have to though is unemployment insurance and if you had received that quarterly statements because I'm concerned or concerned about that we you know we as part of I'm on the carriers as during task force with the money that we for pre for the different grant programs and things like that and so we have fifty million sitting there waiting to cut into the unemployment insurance trust fund to offset you know what's going to become due in January to offset those of that formula for business owners when it comes to unemployment insurance on their employees some concerned about that but I'm also concerned about what you're talking about is so that's the future bill our future circumstance and and I'm also concerned about present circumstance that it's just you know it hasn't been a knife to sustain or it's not enough to sustain until you know we get out of the woods sorry at the I think we've got to me I see kind of. You know past situation tried to get us to where we could sustain but now present situation we're kind of back in the same boat and then future situation with unemployment insurance. you know is is gonna be a potential future so I'm super concerned about present and future but I just wanted to see if either one of you wanted to make comments about that we have that fifty million sitting there but we're concerned also about our hospitals in our health care providers and staff because you get into a bidding war like we saw beginning in the pandemic where you know the state of New York maybe paying doctors and nurses on a whole lot more and so they're gonna leave Arkansas to go there and we have to be able to compete so there's just a lot of those dynamics employee right now but I wanted to really get your perspective on present needs three do you know whether it's what the state can do or what the state is doing and then future needs with unemployment insurance. So The original thing that helped with the fed as well after six hundred dollars a week. a lot of my employees were make more money than what they were when they were working for me. big lesson for me. Coming to figure out how to pick people livable wage. But. I heard a lot of comments from people that said well it's because of that. That your employees are coming back to work and you're not doing business. Actually those people when they're making fifty thousand dollars a week when they were Macon are fifty thousand dollars a year when they were making thirty. They're rich all the sudden I'm not rich but you know what I'm saying. The real read the fact of the matter is. We spent a bunch of the PPP on the first few rounds of paper rolled to pay people stay home. One because of the limitations on what we could open. But to even when you can open up sixty six percent. There's not enough people coming in the E. because of the fear to bring those people back to work because there's no work for them to do. So it's it's going to be a problem and I and some of my key employees that we have now and we're similar I mean I had the. Probably forty five fifty employees that we were gearing up for for this year out of this one unit and we've had about eighteen checks a week now. And several of them have come to me because they're saying this increasing number of cases across the country and the fear of being shot back down again and they know the part of our pit it is we're doing online stuff and everything else and and and their St Paul please if you have a few jobs and they're or wherever they are phone based jobs or whatever. Please consider to keep me on because I cannot afford to live if I don't have the unemployment benefits. So. There's a huge fear out there for everybody and I think you may be and are you trying to replenish the funds so you don't have to go up on the percentage to the employers is that with the fifty million is for the so. That would be great. But I think it's a. And and everybody's worried about this in this personal opinion. How do you put four trillion dollars into the thing and how what we can do with inflation. Maybe they need to put ten trillion I don't know I can cook a hamburger and I do some technology lost more people than I am though that always electronic money you think all the countries could get together and say we're just going to have it all down. For if we have twenty five dollar minimum wage would have twenty five dollar hamburgers I mean that's what happens I I got involved in shortage malls in nineteen eighty eight minimum wage was three thirty five in little rock we were selling hamburgers for three dollars. Minimum wage is ten dollars now we sell hamburgers for ten to twelve dollars so everything's a little relative I don't want to be that way. and I'm glad the money's there to begin the cares and because the restaurant that I had to close in Oklahoma they didn't do that and they've already announced what's going to go up and usually we didn't have an unemployment claim it was our fault so they're divided by zero so we never had an increase but they're gonna have a massive increase in I think the state of Arkansas's done a phenomenal job compared to a bunch of the other states looking to the future and trying to prepare for some of these things and this grant money that you guys made available is unbelievable it's not happening anywhere else So that's a fear for me as well with the bill your fears my employees and what they're gonna do you by I appreciate that it's as if it's been a tough balancing act you know it's it's a balancing act and it's been tough and we're trying to navigate that because we're trying to keep as many places open as possible in as many jobs in place as possible but we also understand the realities of what we're facing so. Four orchard or do our best did you wanna making comments and I have other questions in the queue no really I am I don't even comments that to stem and I never learning thing when I when I just keep talking so learn more when I hear the people talk represented Ladyman. Thank you madam chair. A it's got a couple questions first off. Think about this. If there was of one additional thing that the state of Arkansas could do to help you guys what would it be. Any thank you many things that we can do. That would help your business stay afloat. In addition to what's been done. Unfortunately and I think until the vaccine is out over there some type of Thank you take like Tama flew were whatever. And people get past the fear factor. indoor dining restaurants are going to have a tough time in the The grant money the I mean it's. Just to pay real estate taxes electric bills amend my my August electricity and get water and gas bills close to five thousand dollars I mean is people don't understand is that we buy a pound hamburger for a dollar fifty you sell it for ten dollars will cost eight hundred dollars to pick up the garbage. No tens of thousands and ran depending on where you are I think it's it's it's it's money to be able to stay open and be able to stay in a position to re open because I think. The point is well taken I mean there's I've spent so much time trying to figure out how to keep the business here open and keep my toys go on there's other fields I can get into August or washing dishes at fourteen and I'm sixty two. Seven doing it for quite awhile and I love the restaurant business but for me if it closes down of on and figure out something else to do but the amount of people that we employ and the impact that we have our member my banker told me she supporting get out of this you are tens of thousands of people over your career. And they are. First time workers lot of for of single moms and people re entering the work force out of the incarceration system. And those second opportunities in those job opportunities you huge and I think the ability to to be able to. Be there when it comes back. And I and so I don't have the magic answer five safely what could you do snappier for years get faxing out we're done or we re open right that's a matter thank you Sir but if if we have the financial ability is a small business operator. To be there. To re open a year from now. And. The other thing I personally worry about because of again an LLC in some of these original PPP things were supposed to be given to you tax free the IRS is filing with whoever the powers of the I make a taxable event for the people who spent that money in other words if you got the money spent on payroll you can write off the payroll you that so we've got a hundred thousand you were thirty percent tax bracket you rode off you got thirty grand in taxes you're going to so those of the fear factor to start to creep in and personal loans and everything else and just how long can we hold on so. I hate to say that I think it's it's more funding and and it's an incredible amount of money it's unbelievable. I have the same problem with the glasses glasses yeah could you please call me if you have a comment about that if they're not for organ yes I mean I think as far as what you know obviously another PPP package would be you know beneficial or something similar but I think the restrictions you know I think the people people get it I mean and they're they're no different than you and I mean they're they're seeing the numbers they know they're spiking they're not they known you know restaurants are usually place where people gather so in a you know basically the endorsing really can open the six seven percent of capacity will we or even touch that so the really doesn't need to be any more I think restrictions placed on restaurants because the public is educated and they understand that they know and they're they're looking at the numbers just like anybody else looks at the numbers and so you know they're not going to movie theaters they're not taking cruises they're not going I mean just in on the restaurants of have you an icon to since the since the to make you know I know. No I used to I used to go to the restaurants to see where the restaurants are doing but I don't my wife is is very concerned with three daughters to a college you know one came down with because of it so you know it's touched everybody I think in in such a way so we get a but I think as far as we can the state do it I don't think the really needs to be anymore you know restrictions placed upon business so I think the public is is very where and I think as an operator I mean we we put in air filters as well I mean we put in a highway which is. So the kills ninety nine percent of all viruses and you know we've done things that you know. We're very safe now that I think we've ever been we wash the sanitizer staff wears mask in the front and the back we were gloves we wash our hands constantly we have sinks there so mean I think all operators are are very aware that in doing that to the public but I think it's just you know there is a need to be any more restrictions I think placed on I think once the public becomes more. I want to say com and encouraged and the be back it's just going to take we just need help between now. At the time when vaccines are administered that the we just in that that gap the a gap stop sometime between there to help restaurants to survive because the. You know I'm like Paul I don't know if we are going to be around to it you know we project that we can we can make it five more months based on what our current volume of sales they were awful every day you know a new vaccine rope with the people come back but they're no different than you and I they're not going to come back out to the feel safe and they're not gonna take their kids out until they feel safe so the man I talked to her one of the go ahead well. So. Thank you I thank but in December if we don't have some more funding will probably have to close down and maybe just to to go only. Dr amero an interesting point. And years ago you had to go the health department to be tested to work in a restaurant that's old age. May be restaurant workers need to be some of the front people I mean because you've got people serving you. And you surely don't want to get code from the person is serving. So I don't know if the state can have an influence in that or not but. If you've got a restaurant job and you can be serving the public. For a vaccine online maybe that helps I don't know the restrictions that thing for us is good but there are some people to run a club to to. You know the people a lot of people gather in. They need a break to so I you know. What centered on the restrictions let me ask question I've asked this before other people but And my backgrounds engineering so is this seem logical to me but. In restaurant business you you have to keep the six foot distance and you also are limited to two thirds capacity and my question is if one of those restriction was taken away. So if you just had to have the six feet. Would that help you and capacity at your restaurant to me this seems duplicative and I've asked the governor's staff about that but it is that true or not true ninety four those was lifted would that help your business. Well for me a minute so the. We we see forty tables inside the spacing requirement if I went to sixty six or sixty percent or whatever obviously that's a lot higher than fourteen tables. But because of the distance thing about fourteen tables inside five outside. But I'm not I don't get to wait I mean I'm not to wait on the fourteen tables of got inside the media and the and the pushes so much out there in the fear and I get the figure I mean I. I get food delivered to my house to you know so What you're saying is the fears more restrictions in the distance is that what you it is for me I don't know. I don't know what it is for everybody else but if I think to and we will people appreciate the outside seating. Of this pretty hard come January it's you know we've got heaters on every table we'll see what happens okay one one dish request and then pass it someone else but the Congress is looking at extending or another phase of support the unemployment portion of that you know the six hundred dollars whatever If that was passed would that be a significant help. Do you all. You know maybe not to keep people working but for those people to be there once we come back I mean is that a big deal for you is that something that needs to be included we can't control it here to state level but we can call our congressmen but would that be a big benefit to you to get that extended that unemployment. I would say yes I mean you know grant yes some people were making more money than they would normally make in our industry in our industry you know we employee you know young old and there isn't a lot of diverse groups that we employee but you know it's kind of a a false proper mean we see that you in our business you know we serve seafood vegetarian American cuisine but you know we always say they will in the refund checks come back you know that's when the two or three PL two piece chickens turn into the four piece chickens and FOR for so we do know that when we were more people in the public's pocket they're going to they're going to they're gonna spend it in now so we typically have always been able to gauge that over the years and say okay look when those refund checks come back we do we do see that and we also saw that when the unemployment checks came in there were people that were dining with this that don't normally done with this they were able to in a typically they weren't able to have the disposable income to go out and dine but now they do and and there's not isn't there's really not anything wrong for that opportunity for those people who never get a chance to take their kids out to take me out to dinner and so you know we did see that influx of that no will that. You know replicate itself within you will have Kobe case the spiking and you're giving this additional income or with the state if there's a second stimulus but if this money does go into people's pockets you know are they just going to save it are they gonna people I I think with probably gonna happen my guess is they've gone since July with at the end of July I think that's what a stop in and first of August. Well I think they're now going back and are gonna be paying bills that they weren't able to pay and so you know that disposal income that people used to go out and dying is not really I just don't I don't see that make it a direct effect right away two you know as far as that but I you know like I said I can only go by the gauge of knowing that when it did happen yes we we were able propelled through a little bit of the a dead zone because of I know that that money that went into people's pockets Sir That that help it propped up the Cup this product but it was a false prop we understood it was just a temporary thing. Thank you for your answers thank you of and I'll get a Senator hammer for question three. Are are you see in this and other parts of the state because I feel like you know. I feel like there's a different sometimes our cities can be more of a bubble and what's happening in the other parts of the state so. I I just didn't know if you were talking to other people in different areas of the state who may not. The customers don't have that same sense of fear. that others might have I mean. I I just was curious about that because I'm not sure if this you know there's a whole lot of data to show that there's a spread directly from restaurants or not I mean I think it's more close contact and being with somebody and for a long period of time where is if you're away you know waiter waitress you have very limited long interaction between one another so I'm just curious about that because you know I've. I just you know in some of my areas it just seems very. Back to normal and in a way I mean people have their math fund but there doesn't seem to be the same. A I don't know the same level of of concerned and I'm not I'm not trying to discount it I've had it myself my husband had it was very serious we both have had it and and and and and my children too so it's it's not I'm not understand please understand that. I just know you know. To me they're just seems to be a little bit of different messaging which is creating sometimes a different clientele's response so that was just one of Mike Mike questions I have because of maybe different areas of the state are reacting differently I think Senator hammer question thank you madam chair and and first of all of them both restaurants house standing restaurants over here two years ago but thank you third row glass thank you both your restaurants outstanding restaurants in fact managers as my district my grandkids love your restaurant love the train and I'm impressed you never dropping food on it so it's a cool restaurant what I haven't heard today much of an and I'm just curious are you intimidated or fearful that the department of health is in the room today anything you say may result in an inspection or a unexpected visit from the health department who hold your license. personally not align bottom them in. and help FOR men in an event the A. B. C. and then they're seeing the phone number you can dial to get the form back this is where you're going to behave when you're in the restaurant and both of move come back I said I'm going to go talk to my boss we need to do this everywhere. I really think the challenge I have not had any push back from customers that come in other may be in customers the dial the number. Got the forms that I'm not going to fill this out but and I haven't looked at in a while but ninety six percent of the original numbers or dialed showed up for reservation because I contract that. No line vitamin I mean We want to work with them we want to help them we don't want to spread the virus I mean I. That I've never said this publicly before my life and I hope I'm don't get me you know bad karma somebody calls us and says they've got sick at the restaurant about the fourth thing the manager does within thirty minutes is called health departments that we just got a food borne illness complaint comes back this. Because we don't want people to get sick from us and we look at our food we track and we throw it up in the cloud and we're doing inspections twelve times a day and temperature checking to have some considerations and everything else now we don't walk on water we make mistakes the health department your to help us and they've they've got a limited amount of resources and whatever we can do to help them I'd I'd use our restaurant as a testing lab for them. I welcome but we have a good relationship and and again we don't walk on water we make mistakes. It's. Thank you yeah I think the I look at the health department of assets I mean you know the with the come in inspector restaurants you know I appreciate that because we use as a learning tool you know because if there's something that we overlook again we dine out of you know a restaurant ourselves and as a as a father to I want to make sure that everybody's safe I never will feed anything to anybody else they would feed to my to my family so we always take that a perspective but the you know the health department comes in if there's new regulations all our managers are serve safe certified you know so we are we stay up to date when temperatures and food borne illnesses and things that you sometimes come along that you do do not realize but you know I I think I think restaurants and they should look at the the the local health departments in the state health departments as tool you know to improve your your operations your business so no and you know in some states you have to actually post your. You're a. Your inspection on the window on the front door and I seen in in in other states that you have to do then I welcome that so that you know it to the general public that they know when they walked into the restaurant that they can feel safe and be just give them all aspects thank you so that the only the NE a good dining experience but if safety is a concern there you go if you've got a certification in the state of Arkansas health department okay well and I'm just published Conrad I don't do love occasions we eat out that's kind of our vacation so you know forty five times week I'm out eighteen and you know I I think some of this is an individual's ability to control their own fear and some of this out of your control because you have to live with whatever information is put out by the health department or by the media or by other outlets and I could thank god I can say haven't you got code would a any doubt forty five times a week and and with the testimony that you just shared about health the role you are. Do you what is your input as an organization to the health department say Hey look you guys are you guys are making things that are not common sense here you're making decisions that are impacting our livelihood and have come for legislature and ask for money because of the restrictions that you all are imposed on us because feedback I get from laws restaurants that I eat out in is a they don't understand what all these restrictions about why been cut back to twenty seven percent and so I'd I just like to hear which all have to say is forced restrictions are imposed upon you given the god given your own self imposed guidelines that you just referenced and is there any push back you think that I'd be given to get those numbers back up. I don't know at this point of the selected see the hundred percent that we would have a more people coming in the what we do now. So Food borne illness and the big fear there being an H. word is the fear for appetizers was always for restaurant operators gloves I mean I had multiple restaurants at one time I was going to five million sets a goal of the year they work if you change them. code is a whole new thing and I I know how to do a hamburger. pretty well. And Whatever their guidelines are that they need help on. The I.. If you can talk to the media. And. Or helpful then the restrictions on the health department because I I think they've got a hard job to do and they're trying to make it work the best they can and the best thing now and I think you know as originally the CDC I don't I don't know if they didn't know that this thing was there Warner they didn't have enough stuff for but it was originally do not to worry about where master's wash your hands. And then it keeps changing. And until we learn a lot more about it. Hi I don't I mean I've got the ability to put people on a wait list and let them come in and and I can keep my sixteen tables and let them turn four five times a day. I make enough money to stay in business to get through the spine. So. That's my opinion though so I don't I'm I don't want to speak for the whole restaurant industry there's a lot of people who I know one of but who does speak for the restaurant industry who goes to the health department so you guys are being on realistic here and and you need to include us in conversation who from the restaurant industry goes to the health department and say this is over reach. I think we would go to you know that being a member of the restaurant association Monty my mind scene with one is the one that would be you know she she hears our voices and she would be the one directly speak to the health department you know a and we see the health department as far as inspectors twice a year you know and that's that's required as far as restaurants and into the call the issue now as a whole new thing it's very fluent and if they come in to make sure that and you know it's gonna learn as you go with that as you know making sure that our guests are protected with shields and facemask or be worn gloves are being worn and just limited contact and and you know like I said with our design system where the food is delivered non contact but you know just. Not having catch ups on the table not having condiments on the table I mean I think the health department's restrictions are very warranted and right now and you know that I don't know if any additional. restrictions the be placed on restaurants unless they find you know. Data that says them you need to change your way of operations and I think Senator operators are more you know. Meet your to your talking to us were the ones to decide how we can change our operations to make it work to make a livelihood so far as the restrictions are right now are currently in place. I think the following I think there there being fall okay thank you Mr. Thank you senator Johnson last question now we're going to move on. Thank you madam chair a German thank you for I'm over here on your left to thank you for coming share this information. With this of. I can help with that so you're listening to you and and Mr Christie mention four percent margin and as I recall you go into a restaurant little rock sales taxes eleven percent so the government's making more than twice as much issue are and I'm I'm wondering if perhaps we may be. Be looking at the situation where we and we're sitting up here sometimes feeling very helpless how can we help you how can we help you employees happily help other you another on for your stay in business and I can't help but think that their governmental entities and yes I am picking on convention visitors bureau's that have high and pay taxes a. That maybe they need to scale back how much they're taxing you in the public at a time when promoting people to come to little rock is not working we're not having conventions were not having big meetings I'm just warning if this might be something that could get some relief to you all if your tax burden were at least temporarily reduced act I can help Mr Christopher I've been your restaurant I like it it's great right down the street from you is an empty building what was the oldest restaurant Arkansas Frankie's and it's now closed in there I can see others around the state that it follows by the way side and I know that the the Franky family had some tragedies and other things effective that it wasn't just a covert thing but but be that as it may when I a business is kind of going through a rough period and then we get hit with something like this pandemic then then that's a loss not just to that family in those employees but really the whole state wanted something that's an institution like that and I. I'm asking if you could see away where if we could perhaps. Take a look at your whole cost including taxes Mr Grady mention the IRS taxing your your grant money that you didn't think you're gonna have to be the tax down I mean I could see that could the dominoes start falling on that one we could practically go into a serious depression just over that to is is there a way you could see some kind of of tax relief that is within our purview insert the elation at temporary situation two to help extend that time period that you can weather the storm instead of it being five or six more months maybe to the end of of of twenty one and and hopefully by the end of the vaccine doctor Morrow's talking about would be more fully implemented any thoughts in that regard. Well I think the the the business interruption grant the top there if there's enough to go around that's huge. A that's a taxable event as well by the way. It's for sales tax are concerned and we are the holders of the trust we collect that from the the customer. And you know were. I'm in that sense so the the we we filed for the the business interruption and was to September I've had fifty thousand dollars with the pay roll in October November already. And The total taxes that a paid last year means you're you're talking now. Ninety eight thousand dollars and I'm not saying I would like you to say we'll go collected from the customer then put it in your operation and not have to pay back the other would be held. But it's all. Probably a relative of somebody's run in a two hundred thousand dollar business or tax bills going to be a lot less as well as a two million dollar business. So the maximum an individual operation get out of the business interruption fund is two hundred fifty thousand depending on how much it goes around. We've already had on PPP personal ET I loans EDC two or ninety three thousand. And. Our way out of money upside down by two hundred thousand right now so I mean every thing helps I think just It is some vaccines. What I appreciate the thought process I mean I I it's. I don't know how that would work I mean the state needs to operate to I mean how to. How do you pay teachers has well again I'm not talking about our our general sales tax I'm thinking about the the the the local restaurant taxes hamburger tax we used generally call is for that if the if that and again is literally what what you said was what I had in mind is is the the tax on that ten dollar hamburger might be Dino two percent will that you can keep the price would to the consumer would stay the same but that money at least for the short run I'm not trying to to make as a permanent thing but as we're all in this together that might be of local governmental entity that that benefits from that but it's not really needing to do its job because of the circumstance at this moment could give that up temporarily to help prop up our our local small businesses and again you mentioned there's a cap on it and and it would that make it more targeted to small business not saying corporate restaurants don't need help to sure they do and their people need to work but I'm I'm literally fishing for a way to keep you guys a float no longer there's no doubt warm but when we're paying in six seven eight thousand dollars a month in taxes if we were able to keep those that would be the equivalent of a huge amount of sales volume when you're talking about for five percent margins you reach a break point where it's not. You get down so low about half what you lose your losing on the bottom line the little the alcoholic beverage taxes the big one with thirty three percent or something like that it's that we pass on the consumer what we don't or more in the food business and we do sell it but. For convenience really more than anything. Let no it would it would be a help anything will help. Thank you I mean I think now just to kind of wrap up this discussion we appreciate you coming forward and giving us your information and feedback I mean there's a couple different things that you know or concerning to me and we as a legislature really need to probably think through those things coming into the next session about tax policy and what is being taxable and what's not taxable and how that that might be figured I think sales taxes a passer tax and at that you know the work that we did on the tax reform task force and how that would be really just trying to make sure that we maintain as many jobs as possible and how that can be offset and and looking at those economic development loans and those types of things I think would be also beneficial because I know a lot of people are upside down you know I I know personally speaking as well so and yeah thank you for what you all do thank you for coming before us and for your testimony I think you know if you do have ideas or of obviously worked through the hospitality association you know we were happy to work with them on the most recent grant program through departments of parks heritage and that worked closely and I wanna thank Stacey Hearst on her with her work on that as well in nineteen McNulty for her work so but if you do have those things let us know and you can send them to us and I can give you my email address at the end of this or any of us on this committee or the of ask questions so again thank you so much for for coming and you we wish you very very well well thank you very much for having us and being a state that is more progressive than a lot of other states and help small businesses appreciate that thank you thank you very much. And all rights with that we're gonna move to item after Mr Gilmour and we have the review the Arkansas tobacco settlement commission quarterly report for January twenty twenty three March twenty twenty item F. on your agenda. Appeal to state your name for the record and then you represent a report sure Matt Gilmore department of health. Manager Mr chair thank you for the opportunity today with built with the department of health and I have the most recent quarterly report for the tobacco settlement programs this is for January through March of this year the actual report is there as well believe you have that and you should have a and FOR graphic there of couple of pages we print on color for you. Just goes over the provides kind executive summary some highlights of the report encourages report when you have time it's lengthy but their specific information about each program in their. This is a similar owns format to what you've seen before with password reports we provided to you I will say that you'll see lots of numbers in this report and as the pandemic hit in early March the programs were performing well doing their normal things I think that their numbers would have been much stronger than this these are still good numbers but some of them are down a little bit if you look at the education numbers there on the first page of the top there those are slightly down on the programs that have pivoted and have taken use of make use of technology and virtual settings to provide community education to the various populations one example the college of the health related to offer some courses online did strengthen that quite a bit you can see there in the middle of the page there to the left the increase those number of courses they offered the health departments B. will program and tobacco programs which to a lot of often a lot of their programming on an all in the online version also working with the schools providing materials to give the students but also providing health education in a virtual format working with the schools and other entities to provide that. Moving on down you'll see the service section there and some of the numbers are shown there again these are still good numbers but they are slightly down particularly in the screenings and the exercise encounters with the center on aging across state I think those will increase as time goes on but there is you know some uncertainty with governing group somethings like that the Medicaid expansion program there on the kind of towards the center right the for almost fourteen thousand that's an increase there so some good news there and then as well the I'll just pick a couple more things here the center center on aging across the state again should to the online format to work with the seniors and with care givers provide training for them and support groups. I'm doing this kind of quickly but if you have questions please let me know on the next page you can see some of the research opportunities that were provided still some good news there was some grants they were able to receive ten million dollars they're working with agriculture and water use poultry needs things like that also the UAMS east program the dealt receive some grant money there to work with some diabetes self management with families working with a family group as a whole. Arkansas biosciences to those also shifted some of their funding to work with research related to co that nineteen and it's affected Arkansas and so we'll have some Arkansas specific data soon on that I hope. And then moving on down towards the bottom you'll see the economic impact again these these numbers are actually increases on the economic impact there for them out leverage funds the thirteen million increase also the number of claims were paid through make expansion is an increase as well so there is good news here but like I said some of the numbers are down specially with community education community groups things like that but I think that will increase as we move forward in as we are able to get to the pandemic but there will be I think some fluctuation they're going forward so happy to the questions you might have with the kind of quickly but only billing agenda for today. Thank you and I just appreciate appreciate the report one of the things that I would just really want to you to take back is you know we have an area of a I'm I'm just gonna say north central Arkansas on the Ozarks mean one of the county's Searcy county has a lower average income per person than any county in the state of Arkansas and I know and we needed to focus on certain areas of the state of Arkansas particularly the delta and we've needed to do that and I appreciate that but if we're not careful we're going to see the same things you know we're going to see an appellation occur in the state of Arkansas and the Ozark region and I'm really concerned about that and it's not just nor central it goes over to the river valley as well and so I'm just you know really we have and we have focused and we've done a tremendous job and we've done a great job but we have to focus and some of these very rule areas like I said in the river valley area and and the Ozark area you you know in going west we we we are going to unfortunately I think you're gonna see a huge problem there and so I I think we need to really think about that with our tobacco settlement commission and they need they need to really look at what's happening in some of these counties because because it's becoming a problem. I will I will pass it on to one of some of the other programs to work across the state That I can but I will definitely pass your concern with him thank you are there any other questions. All right thank you Mr Gilmour for being here thank you are seen and we'll move on item she. Miss Lindsay. Thank you for being patience members this is item G.. I'm sorry go ahead this state your name for the record and you may proceed I'm sure remain Donald the state school nurse consultant for the department of education and this is the annual summary. The vision screenings for our school age children. And FOR the Arkansas public and charter schools. At basically it still continues to show that we have a major gap between our school nurse and then our comprehensive eye exams across our state. And in table one you'll see the breakdown of from pre kindergarten all the way through to grade even though our mandated grades to screener pre K. four year olds kindergarten one two four six and eight but we do provide the data for all the grades and then our five year trend that shows Our students required in those who received an exam. At this report was probably and not impacted by coated because this is a. First semester screening. A vision and hearing both are done usually first semester so by March seventeenth the status usually completed and by April first entered into eSchool our data computing system so. I just wanted to make sure reference that and if you have any questions so we're probably anticipating a different looking reports he thank for next year because of co that possibly and we have made some modifications in desi to be able to. Collect some data on that for personal students and their off screen school nurses are offering appointments to do vision screenings and hearing screenings already they've been doing that and then there will be a way to track that to kind of see where we're at also will be able to Collect any other data that if a parent has completely refused a screening processes for any reason and then we also provided some guidance. four considerations with the re opening of schools this year to be able to keep school nurses and our students safe when we are doing screenings so all right but probably yes Sir Williamson publicly changes yes okay all right great what am I appreciate the work that you're doing and are there any questions members committee seeing none we appreciate you thank you for okay sorry represented around us have a question you're recognized thank you and madam chairman white wouldn't stay on Is this miss Lindsay well yes at U. formerly I I re married last year although I met Donald now. I just wanna make sure I understood how to read this It says Sarah on this chart this chart yes ma'am it showing in. The number referred the the number that received an exam in the number confirmed abnormal so referred that would be the number of students that were actually tested. Yes that received the exam they got the screening just the. Now if they're referred is that is that because they exhibit some problems or is it just all the students. So now they're only referred if they exhibit some kind of complication of the screening they either fail one of the one or more of the tennis except for color blindness so these these were all screened that's what the referral refers to a I'm sorry I just didn't does not does with the kids that were referred to see an eye doctor or doctor as a result from name abnormal screening okay thank you you're welcome thank you yes ma'am did you have another question well so so of. So you have a lot more that are referred then those who actually received an exam. Yes so those the go for a comprehensive exam to see to follow up with an ophthalmologist optometrist or a you know a physician for some kind of abnormality yes we have only about thirty percent between thirty and thirty five percent in the last five years that have followed up for that comprehensive eye exam also this is just the the result of. Whether they shop at the doctor's office or not correct okay thank you you're welcome. seeing no other questions thank you for the question thank you Mr Donald's. Sorry about that. Alright thank you so much all rights members we have if you look on the item H. we have already done number six seven and nine I believe so we will just go down these and I'd like to each of these I think at. If they're here I'd like to just. Go through them each individually. Okay number one Mr and and if they're not here we can pass on them and go on until Wednesday we have a meeting on Wednesday that okay all rights absent of love if he's not here we'll just pass to go to that Representative Gonzalez. Add no just just No no that is it I've just other any other questions. All right. And pleasure of the committee. Motion to adopt as their second second those in favor say aye. And opposed that one's adopted and number three. I'm sorry. Senate Gonzales. Could I just make a motion to adopt all of most present am I think we have some concerns from some folks so I want to go through these individually okay. On some of them. I am Representative. Boy eight. three. Yes so this is an interim study proposal on a pharmacist prescribing and administering vaccines as well as probably technicians potentially being able to administer the vaccines as well as we discussed in our subcommittee earlier the federal government has written rules that currently supersede our current scope so once those rules and either because the emergency ends or twenty twenty four whichever comes first then were left in this place where you know we were down this path and then all the sudden the federal government change something and now we're back under state law so it's just studying that so bad there any questions I'm happy to try to answer them. Otherwise I would make a motion to adopt okay is there any questions of Representative for weight. Is that a no questions represent brown did you raise your hand. I was second okay all those in favor say aye. And opposed I'd have the motion is adopted. I am Representative Gonzalez. Did you have anything you wanted to say about number four. Go ahead just make a motion to adopt a part time. Okay is there a second. Those in favor say aye. Opposed eyes have it and that was adopted number five Representative McCollum. Do you want to pressure button. You are here I don't think earlier for the where you know you're not here earlier for the subcommittee if you push a button there may be some questions. I think from the subcommittee there were some questions. Can you pressure yellow button okay don't touch it right now turns G. on okay press the too many times that okay that's okay that they're just with some questions that came up in the subcommittee absolutely and sorry wasn't able to be here earlier so thank you have not been able to talk to every member here I've talked to some of you all and basically what I mean we'd like to study whether or not we want to allow for pharmacists and whether or not we think it's a good idea if the pharmacist in either retail locations or and different rural communities to provide the point of care testing I've talked to I've tried to write down a list of concerns you know section one when you talk about vaccines I have kind of gotten mixed reactions there section two of us were there seems to be more concerns some feels though that would be the most problematic part I think generally it seems like there's more by and for treating lice and ringworm I think maybe there's more concerned on strap and flew in minor infections Other states are doing this and I'm I'm happy to take questions but Really what I would I'd like to do is just let everyone know I'm open for modifications suggestions as well yes so I appreciate you being here this afternoon because that's the purpose of the subcommittee and I really you know I think it's important to hear from your colleagues and to have a full discussion about these and because I there are a lot of concerns here I mean this is a very aggressive you know approach an agenda and my concern you know always is we have worked so hard to try to keep you know rule clinics in place for people and those clinics provide jobs for people and they provide you know services and the relationship with patients and that P. C. P. relationship and all that there's just so many of those policy things that I have questions about how it all will work and you know Weiss I mean yeah that that to me is doesn't seem that big of a deal am most teachers could probably diagnose that and tell you what products that you needed to cut when Bob but you know if her it it concerns me because we have to be able to have hospice rule hospitals you have to have rule clinics to be able to to make it work in the economies and so you know when your I guess for me section two is is really problematic and I'll just I'll just be able to be up front about that and because I think you're you're blurring the lines between what is a doctor and I or and a nurse and and how those people are educated to be able to train and take care of patients first as a pharmacist and whether they're able to do and prescribing verses making a referral for maybe something that's over the counter is different to me than actually treatment and diagnosis you know diagnostics and treatments. And and so I just that would be where my concern is because you know. Like it or not those clinics provide jobs for people that go and shop at stores and. There is there really any there a key component of our economies you know our pharmacies are key components to our economies clinics are key components are our economies and so and that this just concerns me with that but it also concerns me about an all state this I think was senator Flippo as an interim study as well is. There are reasons why you have and I said this in the subcommittee there are reasons why you have sunshine laws at the federal level and there's a reason why you have an ethical at determination between people that are diagnosed seen and people and prescribing versus people that are dispensing and the reason why there are federal sunshine laws in place is because we have had unfortunately events where you know there have been ethical problems and issues because people are making decisions based on their profit margins on what they're what device they were gonna put inside of a patient verses you know what was actually best for that patients and I know that because I know people that were whistleblowers in federal cases AM in a word doctors actually were sent to prison because they were demanding that well this pharmaceutical company that sells me this device will send me to go see the US open or will put give me ten thousand dollars in cash in an envelope under the table will clearly you know we don't want people making that decision based on that we want to make we want to make sure people are making decisions based on what's best for the patients and not necessarily what's best for their pocket books and so. There are those federal sunshine laws in place at the federal level that exists with doctors in fact they can't even received anything like this or a pencil or a pen or anything with the pharmaceutical company's name on it anymore because of what has happened in the past so what concerns me with these bills about pharmacist is that those those things don't exist you know you don't have those sunshine laws in place you don't have that so you're setting up a policy. Issue to me. You're setting up a a a a dilemma and a problem where you know they could be making a decision based on what their profit margin is I get more money on this medication eighth medication versus beast medication be may be better for the patient but I do that on this someone prescribed and dispensed this that makes sense where a doctor doesn't know that like we don't know what those margins are on the medication we know and make that or not we that generally doesn't healthcare making those decisions based on well this is at a physical examination and treatment plan this is what the other medicine fair have you know that they're on and those kinds of things in there trying to make a decision on that and so you know just the reality of of of those kinds of things that unfortunately happen in our world but I guess that would be my main concern about that. Yes they can speak to on of Senator Flippo as here on no and I visited with him privately about that and he okay he he was like I didn't know you know that's just the point that he didn't realize around at talk about so and. So I mean. Thank you I met it's a great point about the in the rural areas some of the some of these job jobs that exist there that might feel threatened in some way and and in certain areas I I guess that's the idea of. Why it's important to think about something other states that have done this I think. Some of the states to have a lot of rural areas Idaho and even Florida and think thirteen something something other states to have some don't do the. They have a collaborative practice. Agreement. Whether pharmacists. without authorization with doctors for the board point of test I mean I guess one here from other members to I mean is yes no that's fine I understand that represent a Payton questions thank you madam chair. A representa McCollum I'm just curious if the pharmacy border association either one has had a hand in helping craft this bill or had input here. Fisher. All right to don't touch anything go ahead. I have not heard from them directly but I'd love to hear. So. Okay well that's all that they would have been. Involved thanks I'm not saying that they did not if that's what you heard I said I haven't heard from them. Okay thank you. Okay a few other questions just don't touch a button Representative McCollum so you can respond Representative Ferguson. Yeah a clear for the to the pharmacist association has been involved. I've averages and I haven't talked to them specifically about it but I do understand that they have been involved. Yeah and I'm sorry entirety privately about it I mean we know it's a Walmart built right. In its early my promise just bad patient care I mean the the part about doing loop and strip test is just completely inappropriate I mean the physician's office doesn't even do a flu or strep test until I have a medical record of done history physical in an exam so to just do those things without any of those in place A I mean it's not like going to get it because the tester go get a flu shot it's very different we're trying to reduce antibiotics were trying to control of. You know how much anybody can what antibiotic is given for strip anyway and to do this without a doctor doing history and physical and having a medical record is just completely inappropriate. But we can talk later but I would encourage you to talk to the A. P. R. in. Nursing board people into the medical board people of the physicians because this is just by a patient's bed for patients is not good care. Thank you and may I think ideally the test and treatment are before receiving the test and treatment that the patient would complete some type of. Medical questionnaire you know similar to what is completed at a doctor's office yeah that's not a history physical exam the exam as you listen to their lungs with a stethoscope you check their lymph nodes I mean there's there's a lot more goes into a doctor's office visit than just filling out a questionnaire and get a test and then to let them go ahead and prescribe antibiotics or medication for it I'm is just unconscionable. Representative brown. Thank you madam chair I think though that this is the interim study proposal and I believe all all of those concerns can be dealt with during the study and then after we are in committee we can continue to ask those kinds of questions so. I would be in favor of this interim study proposal moving forward. Thank you. And and with just a quick question just on payments do you have you don't have anything in here as regards to that right. Irv specifics on the like and I mean. As far as payments or how they would be able to be charged for that and I mean I'm more than willing to. Said take suggestions or modifications on the. I would have to I would just. That would that would just be I mean it back to wet Representative Ferguson documentation and how it would affect like with their PCP And and I doubt those are just things you might want to think through as far as just how it may may interact with their PCP or payment or how it also might affect prior authorization and the reason I say that is because. Sometimes people that presents with these types of issues that are you have in here listed as a minor non chronic health condition I'm not quite sure if I would agree with that definition of it and the reason why is because and this is something to think about at the end sorry number I'm sorry page three. When you say that definition of minor non controversial the Phoenician means the ed treatment or self care. DOT definition concerns me M. just because I mean because a lot of folks if they present with these types of conditions like influenza streptococcus those two I'm or uncomplicated infections those actually there's so many symptoms from those to those those issues that could develop into something a lot greater if they're not treated correctly and we've seen unfortunately too many patients who you thought that they had the flu or thought that they had strap that came back in actually you know had severe mouth cancers and things like that or throw cancers and so and I just I would be real careful about the definitions and the language that would be used in what we we be considering a minor non chronic health condition because that could very well be a symptom that you're experiencing that may be strap or maybe flu that actually might turn into something that's actually very serious that. Treating at short term with antibiotics just pro long sweat actually should have been a diagnosis from the on set that prevents them from getting that cancer treatment and later on down the road down the road and then puts them behind the clock and they're a cancer has advanced and I know that from personal experience with patients that thought that they had those types of things and we're treated with antibiotics and actually we're cancers that were missed so I would just want to be super careful you know about how we define certain things that would just be my comments I don't want you to take my short answer is me not nine hearing. Really truly what I meant is absolutely I'm interested in taking a look at the definitions of modifications that we need to yeah I I appreciate that is it's just you know it's just something that we need to I thank just have to be careful with just a that we don't. Create a policy with an unintentional consequence that down the road could prevent somebody from you know getting their cancer treated or or what have you so I've just seen for I'm just unfortunately seen too many circumstances where. You know we thought it was one thing we try to treat it and then it ended at just be in something and you know very very bad so I'd I'd I just want to prevent that from a policy perspective Senator hammer you had a question I believe actually it was a question of the chair please yes if I I'm just trying remember our calendar dates we've got a meeting this Wednesday yes Sir and then at the call of the chair possibly in December even though the calendars pretty tight corrections so and we do have I mean just to also I mean the the deadline is actually December fourteenth rights summing waste we still have some dates between now and then the people could file interim study proposals the reason why we're having this discussion is just the the subcommittee I want the subcommittees to be fruitful and to have a purpose of the work and so we represent a McCollum is gracious enough to sit here and answer our questions today verses in the subcommittee so. Okay thanks. Senator Wallace. Test toucher green button. Thank god there we go thank you madam chair I'm not a medical expert obviously this is a where the. Topic and I like to hear from health professionals I like to see it get a from a committee in front of the. Senate in the house just to see what what people say about it what our experts about. Are there any other questions. All right seeing none. Measure AT pleasure of the committee. Motion to adopt and second those in favor say aye our and opposed. I have it thank you for the questions and for the input represent McCollum I hope what you understand as for trying to be as instructive as possible thank you. No it's fine but I just want to have to schedule another subcommittee meeting if we can avoid it I'd rather just go ahead and get the work done right now okay. Am Senator hammer. Do you want to have anything to say I'm sorry represented shoot represent a Payton you're recognized. Thank you madam chair I'm just John jumping between bills because I have a general procedure question I'd like to I don't know how to phrase this bottoming I would like to think that we're here for a purpose to make. Decisions on whether to adopt these things or not if it's the. Pre ordained rubber stamp and we're going to devote all of our committee time in session to hearing these then then we must well buy action but is it appropriate to vote one of these down if it's. If the if we are if the committee doesn't wanna spend their time on it in the session amend the pleasure of the committee the pot the committee can decide to do that that I don't there's nothing to prevent the committee from doing that I mean well I've heard a couple of members today weigh in on this is just the interim study kinda like this is just an appropriation. I'd like to take it more serious than that because I mean some of these subjects that we're seeing here. May not have a chance in the session and yet we're going to vote. Five ten hours with the committee time to on. And some of these proposals have been hashed and re hashed in two or three sessions prior so. I just like to make sure that it's still an option to not adopt something. Yes I mean that's the pleasure of the committee thank you that's correct. All right Senator hammer. Thank you Mr chair just confirmation one H. eight eight right that's correct A okay eight you're talking about athletes yes ma'am and pretend to be one so I just want to get that out there might shall serve on this bill the what this does is expand the definition of those that the athletic trainers would be able to have access to to include law enforcement military and rescue services I'll be brief assure this in the subcommittee actually it I have a letter although I don't have it on my persons in the car with where it was requested or it was supported by our military base to allow athletic trainers to be included into this group and part of the reason is they are wanting to be able to let the athletic trainers have access to law enforcement military and rescue services such as firemen of for the purpose of being able to help them condition and also to be able to prevent injuries as far as of on the job similar to what athletic trainer would do for football player in conditioning of this is one of the reasons they want to expand to include this it is and actually technically it it doesn't change anything that they can already do they're just expanding it and requesting to have these three added to the group that they could just for a transparency some have maybe can expressed concern that this would require up city to you know hire an athletic trainer in order to be available to you know they're firemen it doesn't do that at all this is permissive and it just opens up the opportunity for athletic trainers to have access to be able to offer their services if passed to law enforcement military and rescue services. Okay I just have a quick question it is this organized activities or just activities in general. It and I believe that on the letter a on line thirty because be was added it just added it you know just made it as the main point of a but I guess I would have specifically when you say organized forty referred to make sure I'm thinking the same thing you're thinking. And. That to me like activities related to the law enforcement would just be like a general thing where as an organized activity of a military that would be like or rescue service to be like a. Like a practice rescue scenario verses like just normal everyday activity does that make sense yes ma'am and okay because I'm in I'm going back to lake. I'm just I'm just curious if you're trying to which one you're trying to do that is just a matter of clarification for myself sure understand of they would like them to be available at their discretion so that if they did go out on a training exercise our state perhaps like a lot of uh police departments of fire departments in the military have you know exercise room training room similar to schools that have those for their athletes that they athletic trainers would be able to work alongside them of you know to help in the condition process but part of the part of the intent behind this also is by giving them access to these three populations that with the athletic trainers being legally to be on site and offer their services it would help prevent injuries you know possibly even prevent of some workmen comp claims just by being able to participate and and have the legal presence to be there okay thank you. Some of the. Well I like this idea actually I like a lot of because this preventative and. With firemen there's an example you know these these fireman our own twenty four and off their own forty eight off twenty four whatever and lot of them as center said they they have exercise rooms they have to be physically fit to be able to handle these water hoses it's it's it's I've done that somebody all may have done that it's quite physically demanding so it it would be very very beneficial that these people be trained in how to not exceed their physical ability. And that's what and they have a trainer can do or how to develop certain muscle groups to be able to do certain things that they do and if you've ever held a three inch firehose you guys know what I mean I mean you can't do that and you need to know what your limitations are so that's one thing they also you know have exercises with a burn down old house in these athletic trainers could be there to observe and and know what kind of development they need and also on the police side it's is really needed because they don't get. The athletic training or the programs at the farm and get so I can see where this be back very beneficial to a city has a police and fire department all right I'll make that as a motion and is there a second. Second okay all those in favor of adopting this say aye and opposed ayes have it and it will be adopted next one is Senator hammer number ten is what number were on all right thank you madam chair. In a may madam chair if represent spring or would like to join in on the conversation this bill also has her name on it with the chair allow that as well yes that's fine and yes she I don't think she was present early or maybe she was go ahead okay show more work to the main points of what this bill does on page one line twenty eight the country it creates an additional spot on the state medical board to allow PA to be on on page three line twenty nine it amends the P. a committee. it a light yellow line page three lines thirty through thirty three it it ally it to. I'm sorry did I mensa PA committee. On. Page four line twenty one to twenty eight it to re establishes the definition or establishes or critiques the definition of a P. A.. On line on page and this is covered over three sections of the bill but page five line twenty nine page six line fifteen page eight line three of it establishes a supervision agreement between the P. A. and the position on line on page seven line five limited prescriptive ability. On page nine of. Nine eleven it also has the accountability factor with the supervision agreement and then on page ten line twelve of it defines the ability to operate under emergency declaration those are the are the main points of the bill and I don't know of representatives free would like to add anything madam chair if the chair would allow she would like I'm not sure. Okay by Representative Springer. thank you madam chair I would just like to think Senator hammer for presenting the bill on behalf of Of the doctor who contacted me and I'm new to this process so I really appreciate him taking over in going through it thank you very much. Alright thank you am I would I would just say to to Representative Springer and you know have you have you been able to of this it with the medical board about their current system I know we have a physician you set up for a physician contacted you that have you visited with the state medical board I have not okay that's something I need to do I'm happy to do so yeah I would just recommend you you kind of going through that because that may of you know you might be able to accomplish what you want to do without this is a very drastic change of where. And. Because because what they have right now is is it a pretty comprehensive with physician assistant so I would just I would just work with them yes ma'am Senate try to work with them to see. About what we can accomplish it is that is not as I understand it is just the it it it seems very simple to me and I may be incorrect but they're just wanting to be a part of the board itself so I'm at I know that they're there to receive guidance and assistance from the first on the board they just want to be a part of it board some but I understand what you're saying thank you yes and they'd and FOR minders I would just contact them to kind of discuss with them so that you have a real clear lay of the landscape because there is a very there's a physician assistant committee that service under the medical board and the issues go to them for recommendations and all of that where's your if you put somebody on my concern would be if you put a physician assistant on the medical board itself where ninety five or ninety six percent of those issues that they deal with our for physicians than not one person may not have the same it's not a peer to peer type of a situation so I you know I I know they've worked really hard to make sure that the physician assistants have their own committee in their own issues but I would just recommend you know talking to the medical board and and and those folks involved with the and at the end yes for your information I do have a relative who is a physician's assistants and they and it is my understanding and informed from what I've seen heard do is that you basically does the work of a doctor and the doctor's just there to supervise so they have great wealth of knowledge in order to perform of Neil the services that a doctor perform so I'm well aware of what the medical physicians do not in and when Mr the doctor contacted me I thought that that would be a good idea so I thank you and I do agree that I will make contact with persons on that medical board thank you very much Representative Payton has a question for you. Or four Senator hammer thank you madam chair a I want to understand the board aspect of it but that's not scope of practice someone drill down on what is the scope of practice were dressing here when it says amend the supervision and prescriptive authority of the P. A.'s I mean can can you can one of you point me to the portion of the bill that's actually just changing the scope of practice manager may address that yes please go to page seven Representative Payton lines five through sixteen and I'll tell you why this is in there as it was explained to me is that the in the event that the position assistant working with the position but the position is not able maybe to be present to get the script written this would allow the physician to do it on a limited basis in fact if you look at line seven an opioid if prescribed in only a five day period or less there are some restrictions that are in here that creates some latitude of that I actually benefit the doctor but you know keep up keep somewhat of a close rein on it as far as what the PA is able to do. Thank you thank you madam chair the manager I make a comment response yeah and I would just isn't that I would ask you a quick question on that five day period or less in isn't that something that we put in place for all opioid purse or for the at the majority of the of your prescriptions I believe it is and I believe not I'm sorry go ahead and I mean I would just I would just say that. Not sure if that I think that's just being consistent with what we passed on. For all prescribers on opioids but I was making sure that I understood that correctly and and I believe you are correct it's just I'm not sure that the P. H. had that before they want to make sure to align so as not to give the appearance of getting out ahead so I think you're correct on your point in this is probably just a extra emphasis on the point. Okay. I I again I think physician assistant at what point do we become just physicians. I just suggested thought what will and amend sure think your concern. Is addressed in the bill on. Good. Sure certain it correctly. What a page five. Twenty nine through thirty one. The physician assistant may provide healthcare services of a physician assistants license otherwise authorized form under agreement with supervising physician I think there's a a real connect the in let me double check the thing line page six. there was one thing I did not mention the that this bill also does I did not mention that on page six line twenty eight through thirty a PA cannot pronounce currently and this would allow for death pronouncements On page six lines eleven through fifteen A physician assisted may perform a task not within the scope of practice Raj physician if the supervisor position has adequate training over such bill surprise you refer arrangements to ensure competent provision of healthcare services by the PA. Okay. All right thank you. Any other questions. yes at the pleasure of the committee. Motion to adopt serwis second second all those in favor say aye. And opposed of habit okay Senator Flippo. Alright we're gonna I'll contact him to be here Wednesday. Yes. Okay okay go ahead. Senator Flippo. Senator Flippo asked me if I could run this because he had a matter that he had to get back and take care of I'd I'd certainly do not mind providing some basic information of however full transparency disclosure because this deals you know with pharmacy issues if it is not overall placing to the committee I'd like the opportunity to be a port down he can present wind shear the chair would rather wait and present Wednesday I'm just off from that a. Okay night per se that I just. You know the the purpose of an an arms to the proposal is just to try to give feedback to try to make sure that the bills get closer to what could be and agreed to process to be able to be fruitful with our time and so. I mean it's it's you know it's the pleasure of the committee but again it's just something that. You know if we could try to work some of these Kinks out or we're going to be really under the gun next next session so yeah I guess my concerns I've already visited with him personally about my concerns with that so that the pleasure of the committee we can we can go ahead and pass that if you if the committee would like to. At or if people have questions for him. So what's the pleasure of the committee. Like a motion to have the represent of Ferguson how may I mean I don't it's not that I particularly mind doing it but if we've already not allowed it for the other people that work here things a little unfair they can show up wins the gap that's fine I've already got that will just make sure will put these at the top of the agenda on Wednesday so that way doesn't it Senator hammer in a position where it can answer a question and I don't want to do that somebody okay we'll just pass over could you just hold on to that yes comment to just a kind of wanted to comment to represented Peyton's question are there was I mean I remember one interim study since I've been here that did get approved and that was for natural gas and. But at I don't know I mean I I don't know that I disagree with you that we shouldn't be may be more careful that instead of just passing everything but I mean that's not been the policy or the practice. Of particular you wanted to cope with the primary were primarily the reason for the size phase though is because and the reason for the house rule to present things thirty days before the session is exactly the S. dislike she's presented this bill and they're gonna be a lot of issues with that position assistant bill with the medical board of because their lot other groups under the medical board besides just physician assistants by day administer for a lot of different groups but that's the reason we're doing this is so the person before they present the bill knows who you know so the person with the opposition can get with them and discuss it and and flesh it out a little bit before the session so that I mean maybe we shouldn't be approving the mall but but I think we're meeting the goal of introducing them early enough that groups that have concerns no it's coming in can discuss it with them so I'm and I agree with part of what you said but I'm also agree with Representative Payton because I do feel like in the past when I first got elected that this body we actually did interim studies I we studied them and we had committee meetings on them and we tried to work the issues out before we crammed it down everybody's throats during the session when everybody strapped for time and so I feel like as policy makers we should take our time and we should create good policy and we're not doing that and I that is not this is my shortened version and attempts to be able to do that because there's a lot of questions here and and I mean no disrespect but I get called all the time from people that say Hey I want you to you know follow bill because this happened to me well that's one person you know and so when you're creating policy it affects everybody in the state of Arkansas so we should put some effort and time and attention and we should listen to each other and we should have a dialogue and we should have to pay. And there should be a process and if we see something that we know you know we know we don't like this then why should we waste time on pursuing it in the session I think we should be thoughtful mindful policy makers and just be honest about that because these bills create a huge clog of time and we just end up having you know fights in issues which is why I try to run a bill about this but you know and I I I want us to be thoughtful and engaged and try to have respect for one another to do it that way so I agree with both of your comments I suppose moving on to and. To Representative Penzo is Okay are there represented Penzo. One senator Ballenger are you still here yes okay someone recognize you to talk with quickly just if you want to talk act are they if there any questions he went through this this morning. I think we've given a lot of feedback do you want to say anything quickly about this will there is a few questions that I can answer now okay There were asked the. There are twenty five of jurisdictions in the US to do license now through Pat natural panic physicians or natural path doctors whichever you prefer and then in most states that do have Full the they're they're treated calico the family practice physician they do have a limited to Prescriptive authority but like I said those are all things that can be discussed in further I'm more interested in them being. in no. Part of the healthcare team with. In these in the owes and I'd be happy to. Answer any other questions or in okay but this but your bill as it is written does not provide with for any prescriptions authority pretty much just set up the the set up to the under the license up under the medical board okay. Right any questions thank you for getting those answers twenty three twenty five jurisdictions you means states will remain states and territories I believe a Porter Rico to US Virgin Islands and then the rest of the worst okay gotcha. Okay Representative Payton has a question I'm just full of questions today thank you madam chair so the Penzo I'm trying to figure out or we. When making something less restrictive or more restrictive you're awesome there are wrecked already people practicing in this field. Are causing them to go through new hurdles or we actually opening a field to people that are interested in there are there. I know there were I don't know if they're still or because it's very it's not very. The friendly in Arkansas practice like I said for example when I went to take my food allergy panel I had actually they couldn't draw blood clinic because she's not treated as a doctor in Arkansas as she went to medical school in Arizona but in Arkansas scantron will put. And nobody under control my blood so I actually have to go down to one of these blood drawing places they give me the vials that package it up by send it in and she could go over the results with me so they can't practice to their. Training level in Arkansas they can't bill insurance they can't act. Like a medical professional they're just consultants so and and like we discussed in committee there actually are people that call themselves natural passage did not go to medical school they took a couple week training course so for those people they can't call themselves natural pet the positions now but will they still be able to do what they're doing they still can I mean I don't wanna run into granny Clampett over here in the halls of the capitol when this bill hits the committee and yeah yeah I know many I'm not I'm not trying to I'm trying to open up. The the people that have been trained that they can practice to the full they're full ability in the state and be treated as healthcare providers instead of just a joke which is kind of what they're considered because people just don't understand what they are they don't understand that they actually went to medical school that they actually have medical training and they do have you know now when it comes to their prescriptive authority it's reduced in many states they can't you know schedule ones are off the table and you know but so if they went to medical school and they have all that while why aren't they a lot what's preventing them from bill license now we don't have a pathway in Arkansas for new come licensed now we do for Dr well they're not they're not indecent or not DO is there in these so we have abilities for that went to an indie medical school no natural path physician school not a medical doctor school so it's it's it's a their training is comparable but different. so like that like a do you know lot of people don't realize Beals can do surgery like I said this morning one of my favorite orthopedic surgeons up in the northwest Arkansas as a DO is not a medical doctor is an osteopathic doctor so I mean there's there's just different it's a different training. Path for the it's just. Twenty seven went to medical school it's not the same medical it's it's did no it's different it's different but they study it's it's a somewhat similar course work they just focus more on natural healing instead of drugs. So like like a like I was in this morning I went to three different doctors. and nobody could really figure out what was wrong with me they were run all kinds of tests to have my own prescriptions you know everything from skin conditions joint pain I called the girl up that I knew that I went to college with who was an indie and I told her with phone was going on she's like oh click you get food allergies commitments do some blood work and we can get this figured out so change Monday joint pain when way could take in all of the prescriptions I was on total dermatologist the Hey I quit taking that stuff made some dietary changes I don't think that's what got rid of it. And it was it was just like yeah was so I mean it it's just a different you know some people are willing to make lifestyle changes to fix health stuff and I think Arkansans deserve the opportunity to. Go that direction if that's what they choose instead of a of a metal door medical doctor not saying that. They're better than medical doctors it's just a different philosophy different Just just just completely different philosophy on healthcare no I don't I don't want to see I'd like to see more can under the medical board with Indies India does not create a separate board and have a totally different dynamic like they do in some states I think they need to work with medical doctors I don't want to set up the. Any kind of a. Collaborative agreement or anything like that I just would like to see people the refraction other states be able to come in Arkansas. In practice like they would in Arizona or. Any other state. They're currently practicing in. Thank you thank you madam chair so just I mean again this this interaction right here is a perfect example of why I think interim study proposals should have the ability to have like. Representative so could bring in somebody that can answer your questions you know directly about their education their training and what you know what they did to to to get their degree it's it's very different you know from a medical I think it's so it's not an imminent the medical doctor but in in the narrow house thank Dr so I had the conversion of that but I would argue probably very different I mean. The orthopedic surgeon that did my surgery on my back is the DO but also went to residency you know for surgery and all of that too so but they're just they do different things and so and I think that's the. Distinction. Representative Ferguson I just for having a maybe you all understand but essentially osteopath sewer D. as in M. days who are elapid the doctors have really become the sign provision that a do the same residencies they both go to medical school for four years they did it they both take the same board exams and all of all of that and amend Davis easily become the same at one time osteopaths were sort of a different profession and much like chiropractic but years ago that became so similar that they really are accepted in the same residency programs and DO essentially the same things as in days not to read the doctor's is more like chiropractic or something I would say it's a separate school that for four years that they get a natural piping degree the they do do some things that similar chiropractic or even acupuncture I'm not saying they're simmered coverture I'm just saying it's not a medical degree it said education bills completely different profession educational it that are out there not licensed by medical boards and like osteopaths women we could set up a new board if you want to them trying to avoid that. Senator hammer. Thank you Mr chair of represent Penzo I was wondering if you because based on the test will you just gave there was a conflicting opinion between your medical doctor and the doctor that would be a licensed under this do you anticipate that the medical board. Or what's the appeal process if the medical board denied somebody a licensure because say maybe the majority of people in the medical board don't agree with us the process of treatment. That would be allowed under this under I'm just wondering how you can resolve the conflict if you have disagreement. That's a good question senator I'm hoping that the the. That if if someone's allowed to practice in another state. The. They would be allowed to practice in Arkansas. as long as they want to accredited schools it is for that a man that's trouble shoot down the road I mean do you do for see that there would be an issue. With the medical board not granting licenses to. Measure by the positions well I'm just trying to you know look at all the. Potential center and one thing that always by putting them under the medical board you're creating that potential but but let me may be asked another question may be relevant to this one and that is Our. Right now. There's no bill to be licensed in the state of Arkansas. AS one of these doctors that's why you're running the legislation so correct how many other states. License this type of position. Well that's that's a centers twenty five jurisdictions it currently license now not all those are states because some of our territories like I said Porter Rico US Virgin Islands so those are the two that stick out of time and it warned state so I'm assuming that there's you know twenty two twenty three I don't remember how many territories it were on there but so there's at least twenty two twenty three states that do currently have licensure for Indies now I know there's pending legislation and multiple other states coming up This year next year such different states do the legislation legislative sessions at different times but I do know that there or other. States that are looking into allowing licensure but I don't know how many of the top of my head. Well I'm I'm just offered up for this additional having problem with them just like an you might wanna have a discussion with those in and I hear you don't want to set up another board but at the same time there needs to be some sort of process work there's disagreement you know these people have an appeal process and and and maybe there's OR one in in there I'm not aware that maybe the chair is that if the medical board were turned down one of these individuals if we passes what's the appeal process where they can if they feel they've been viewed. Unfairly how can they how can they go beyond that just because of the cut but if when consider looking well yeah I mean I think that's just a conversation you have to have with the state medical board and sure the same appeal process for anybody would be the same because the way you've written it says an update shall license you know it's not and if it's they shall license them if they meet the certain criteria so the appeal process is probably that was something you might want to visit the I would just off the state like in your practice of neuropathic medicine means on page one line thirty six. And and I know you don't have prescriptive authority listed in here is you're just trying to set up the license but you just might want to look at that because drug list methods and nonsurgical methods might conflicts with. You know what I'm saying so you know me even like I said this instead to create a new board I knew that would be highly controversial that's why I wanted to put on the medical board and and I'm okay with them even determine the scope for DO is I'm sorry in these in the state initially of because I know a lot of people are real familiar with what they do in it and that. Baby steps this can what I'm looking at you know I'm okay with it being on the medical board have an input on you know the the scope that they're comfortable with because like I said I I'd like it to be complementary to Indy he's or DO is in in these. Thank you any other questions pleasure yes would you educate me on something with the board because this is where they're going to have to determine the criteria by which they would issue the license do they possess that soul ability or does it have to come through rules or does it come by the legislative branch when it comes to something like this. What's that one more time does the medical board have the the ultimate authority to determine the criteria by where of these positions. And how they are licensed or educated did do they have the sole ability to do that or does that have to come back before us in any capacity of legislative branch. A cancer rules it does come to writer rules yes so I mean if so if like say you pass this bill as it is written the main page three pretty messed dictates Arkansas state medical board shall license as a natural path that physician an applicant who you must meet these different criterias now they have to be at application has to be approved as they have to pay a fee but then they also have to provide the evidence of an accredited And that might be some language and again if you want to pursue this I would recommend working with the state medical board if you want to pursue this and and see if you can figure out a way to work with them on their processes to so that it kind of lines up the match because they they also have like respiratory therapist underneath them and you know different types of of folks though then then all of this would have to come back through the rule making process. Thank you. I mean. Especially like number to the Arkansas state medical board has the sole discretion to issue a license by reciprocity then that would also come back to us through rule making process because they would make that decision but then we would have to approval approve that will make sense. Okay any other questions pleasure of the committee thank you. Pleasure of the committee. The potion motion the second thank you all those in favor say aye and opposed ayes have it okay Representative gray is not here and. I want to go to I can go I can do it for her but and I want to go to represent of Gazaway he this is on and. He has one and that we have passed out or we can pass out in a recognized him at this time. In Mrs under other business item I. That oh sorry you need to be lit up there you go there you. Try to make this real quick This is a bill that was brought to me by K. nine a police officer handler in Paragould. Based off of a situation that happened in Jonesborough in two thousand eighteen involving a police dog named gabbro. I just going to give you the background of the situation there was a standoff in Jonesborough all. with a shooting suspect in two thousand eighteen. where there were negotiations between the police and the swat team and this standoff suspect to it shot another individual and after five hours negotiations the swat team decided to send in gap of this the police dog. to try to break up the situation and when they sent the gap in gabber was shot five times in the line of duty and from there was immediately rushed to surgery and he survived that surgery and then went on to live a couple years later and then ultimately passed away but so I was contacted about this because this. Particular incident brought this issue to light that when police dogs are injured in the line of duty. It violates the currently there's not anything in the law that provides for emergency medical personnel the ability to do a transport and so what this bill does and this is been done in other states is it allows emergency medical personnel at this is the narrowest of all bills. Emergency medical personnel only to transport police dogs only not every dog but just a police dog and only police dogs who are injured in the line of duty. To a veterinary hospital or clinic for treatment or care and I just say these canine Police dogs are a very highly trained their special assets of these of police departments now they do everything from drug recognition bomb sniffing again DO the the suspect take down like you saw and gavel situation with the swat team but these are very valuable assets and members of the police force and whether injured they need to be able to get the care that they need and when I talked to paramedics. Who have dealt with these situations what Intel is apparently this happens more often than you might think one of these dogs being injured in the line of duty so again this bill provides for them to be able to do the transport and to provide certain emergency. Medical treatment only so not trying to allow anyone to be able to practice veterinary medicine not trying to be able to allow all paramedics three entities to provide medical treatment to your family pet or any other type of animal only police dogs injured in the line of duty. And the emergency. Services and treatment only and then the last part of the bill exempts those who would render treatment or a. from any civil or criminal liability in doing so in my estimation I want to make sure that was inserted there a paramedic or any empty whose do and emergency medical treatment or care on a police dog is really acting kind of in the nature of a good Samaritan and they should be exempt if something happens that the police dog on the way to the veterinary clinic or the hospital on the put in the dog dies. The person who tried to help and render aid should be held liable for that in any way and so I wanted to make sure that they were exempt there and then they they may request they certainly don't have to but they may request a member of the law enforcement agency to accompany them on the transport and I will say this doesn't require if a dog is injured in the line of duty that an EMT or or a paramedic provide care but they may so it's not a mandatory but it's a discretionary. And with that I'm happy to answer any questions. I'm sorry at my only my only critique would be to also say otherwise known as the gap acts that would be one addition yes I agree with that we'll have agreed that a percent because you know this was those of us live in Jonesborough so this you know covered on the news quite a bit and it was a it was a big incident really was and what I I just had a statement but these dogs are very important and is represented Gazaway their their valuable assets very expensive speaking of someone who has bought one of these dogs they're very expensive if you can the other thing is most people don't understand this they see the dolls given the drugs are going in and saving somebody's laughs but these dogs are hard to find they're not readily available they're they're difficult to find a lot of small town police forces can't even get one and if they can get on the can afford them so it this is a very good bill I agree with you. Thank you at the one also say that the senator Wallace and Representative Ferguson are currently co sponsors on this bill I certainly appreciate them and they may have some comments that they'd like to make on it house. I'll be happy to co sponsor with. That if you go the gavel bill yeah that would go to do that with the gather active mine my request Representative Ferguson who wouldn't sponsored right to fill the bill he doesn't like a bill about dollars. Yeah I think this is the one I if the we can end on good right okay Representative Payton you're recognized thank you madam chair Representative Gazaway is there anything in this bill that would be interpreted to. That would prevent somebody a police officer from transport in a a dog before the ambulance could get there are no words you have a injured dog and and it needs to get somewhere immediately are they going to construe this is. Keeping them from loading the dog up and taken it somewhere and they have to wait for name billing term or emergency medical personnel. That's a good question I don't think so because this is discretionary for emergency medical personnel just to provide them with the ability to do this and not go beyond their license but I don't think anything prohibits a police officer for making that decision immediately like you know I need to act right now I think I instead of call in somebody that taken on fifteen minutes to get here I can just. Put the dog in the back of my car and get somewhere now I don't think there's anything that would prevent them from doing that and I hope that they wouldn't take it that way and if we need to insert some language in there to make that clear I think we can do that well like the intent of your bill but that does concern me that sometimes you pass something like this with the greatest of intent and then it gets interpreted and becomes restrictive in some way so you might put some unity in there for somebody that would transport the dog other than emergency medical personnel so for example maybe we can say something like nothing herein what would prohibit a police officer or. person from transporting the. Injured canine themselves I'd like to see it thank you okay thank you madam chair thank you good good good addition Senator hammer thank you Mr chair Representative as we the mansion of. Is there anything that would need to be added to this bill or you're currently covered in law now that the expense associated with the injury of the of police dog could be charged against the state or against the individual who injured the dog. That's an excellent point I I've never thought about that but But I think that that is an excellent point I'm not sure my thought was on it was in when I met with the industry groups from the ambulance services and talk to the very next veterinarians about it when the issue of payment came up nobody seem to really care and I was kind of surprised because I thought that would be a big issue for all the stakeholders involved about who gets paid when they get paid really nobody seemed to care. But I think. They have someone causes that injury intentionally through a criminal act or so on and so forth it's certainly be a a good idea to make them potentially responsible for the payment and I just wraps as a friendly suggestion full confidence you know that your if you would just maybe take that in consideration because to a Representative Ladyman point well go there's a lot of investment not only financially but personally in these the in these police dogs and I would like to at least make sure that there is an Avenue whether cover otherwise in law or if it need to be added to this that restitution could be sought against the against the estate or against person themself the the creation injury and the second thing is use work as a medic for members as the medic driving the unit we had discretion to upgrade from a transport to emergency and we had certain coverage of liability of respecting the value bill T. of this being a police dog yes. It is not a human life and I would just offer friendly suggestion not talk with the ambulance association and SM if there needs to be anything in this language that would give the ambulance personnel that if they choose to go to a you a true emergency mode that they would be afforded the same protections transporting of no disrespect an animal versus a human life because of like close every Leupold keep anybody from you know taking advantage of the situation in court and I just offer that as a friendly suggestion thank you manager. Thank you in response real quick and I'm not yeah not sure that our men dressed exactly what you're saying there so that we may need to follow up on that but what they one point to be made is is that. This allows for transport in the event that there's not a person that needs to be transported I mean let's be clear about that if the if you're on a scene. And where there's been injury to people and the dogs also injured you you're not gonna put the dog in the ambulance and leave the person lay in there and so it we do make that clear in here but I think the situation you brought up was a little different than that so what the I'll definitely follow up with you on that it yes ma'am chair and it is ocean imply anything and I don't think you take a survey I'm just just trying to look at at the giving that ambulance personnel clear coverage and the ability to make the distinction as they begin the transport they have to upgrade to emergency status they have the same latitude with regards to the police of dog as they would with you know human life chose to make sure that they're they're covered thank you. Thank you. All righty thank you and A yes so motion motion to pass there's a second those in favor say aye opposed I'd have a great and then the last one thank you Representative Gazaway for the last one I'm going to have permission to do for Representative gray it's exhibit H. thirteen AM quickly this was based on rule forty six that we all tried to come together on rules and regulations but couldn't get there when it came to cosmetic procedures and so I'd just covering our bases there we're gonna try to work this issue out during the session with all the parties involved which is the state medical board the state board of nursing and am I other folks so that's what this interim study proposal does and I'll be happy to answer any questions Representative Boyd. I make a motion at the proper time to adopt this all right are there any questions for me that I can answer on this for anyone. Okay. A motion and is there a second second those in favor say aye and oppose thank you members I appreciate the back and forth in the dialogue I think it's really helpful and to for members to have the ability to get input from each other represent of Ladyman so just so everybody understands we've got three interim studies to carry forward to Wednesday's meeting right number will not to I'm sorry number one and number eleven correct correct and then if we have interim studies anybody that you know you don't see it on here you don't think you got approved you need to bring those let us know email me or Senator Irvin yeah you take on the agenda right technically you have to December fourteenth and so instead of us calling the subcommittee we Hollywood just call a public health committee to deal with the in the committee itself between now and then because we would still need to adopt them officially and hear them if anything is filed between now and December fourteenth just so everybody's familiar with the process but you know again you know I would love to have had these things early on to so you can bring people and to testify because we would be nice to hear from some folks on service some of these issues but let us know so we can on the agenda right right and also members and so we will have a public health committee meeting again Wednesday December second at one PM we have three health department rules and ten at DHS rules for Wednesday's agenda so please read you have homework read those rules and meet with whoever you need to meet with in the interim between now and then on any of those rule propose rules that are coming Ford okay and is there any additional business to come before this committee I'm also wanted to say thank you to our vice chairs Senator Wallace and represent a Ferguson you've been tremendous assets on there to me and serve Representative Ladyman on this committee so it's been off the market with cal all right. I seen that we are adjourned.