ALC-Hospital, Medicaid, & Developmental Disabilities Study Subcommittee
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Unknown speaker
0:00
Thank you.
Thank you.
Thank you.
Thank you.
Thank you.
Thank you.
all right chair sees a quorum if everybody get their seats we'll get this committee started and I just want to personally say thank you
for coming Monday morning at 10 a.m. I know it's a beginning of the week.
I know it's hard for my colleagues to have to drive a lot farther than I do. So thank you for making an effort to be here this morning. I really do appreciate it. I think it's a very important committee, and I think Senator English and I both appreciate everyone that's here this morning and your excitement to get some good things going in our state. I really am excited about this committee. So we need to, the very first thing that I need you guys to do is look and see that we have some binders here. um senator english asked for us to get a binder made because we have so much information that's going to be thrown at us from both of the areas that we're working on we wanted a binder to keep
it all intact so you guys can find the information that we don't lose it i know lots of times i lose the papers i wanted so uh staff is going to make sure we have all the discussions that we have all the information we received will be together in our binder so you can find it easily there's um it's divided up remember we have two subjects we have dhs that we're working on and we also have workforce study that we're on so they have two different tabs for you to locate the things with workforce and things with DHS and see we all have a quick reference sheet listing required reports and relevant information has been provided behind each divider followed by legislation
the special language for each study and to facilitate easy access to details specific to each study the tabs are included to divide each meeting date and last month's meeting information has already been incorporated staff requests that you leave your binders at the end of each meeting to ensure that you have the necessary materials for the next meeting and they'll put in the information that we received today into the binders anybody have any questions on the binder that you have in front of you okay if you look there the first thing that we need to do is to consider the adoption of the comprehensive review timeline
that we had if you look the very next exhibit b is the timeline remember we were given specific timelines and the legislation that was passed for this work for the study group to follow through so um if you guys will take a minute and look for that timeline is right behind the uh agenda for today's meeting okay do i have a second for that have a motion a second all those in favor all those opposed okay we have approved the timeline that we have set forth on exhibit
it be to move forward with that and i'm sure that there'll be some more amendments to that as we move forward okay so the first discussion today will be from uh department of dhs so for the members from dhs that are going to present today will come forward um and while they're coming forward i'm going to tell you colleagues that we're going to have a different subject from dhs at each meeting next meeting will be uh child workforce services so if you have questions that you have from your district that you would like them to have answered when they come our next meeting will be in august so i'm going to send an email out through staff so even all
of the colleagues in our house and senate that have questions on workforce services at child excuse me a child development child excuse me i'm going to get my brains working yet let me read it we've got so much going on today so the division of children and family services will be in our august meeting so if you have questions on digital children i know that i do for my district So I'm going to send an email out to staff. Staff will get it to all of the members of the House and the Senate. So if they have questions, DHS will have some time to look at those between now and August
and maybe come with some answers to the questions that colleagues send out. So this is a time for us to work together with DHS to make things better. This is not a gotcha time. This is what's going on in our districts. We want things to be improved and better. And the only way they can do that is if we know what the concerns that you have back in your district. So if you guys can send questions to DHS. but i tell you what we'll send them to staff we'll send them to katie and katie will get them to um to you okay all right with that if you guys will uh recognize yourselves who you are across the board and then we'll let you begin today we're going to be discussing shared services at dhs thank
Speaker 10
7:16
you good morning everyone christy putnam secretary arkansas department of
human services good morning I'm Misty Eubanks and I'm the deputy secretary for operations and budget DHS good morning Janet Mann
Speaker 17
7:36
deputy secretary for programs and the state Medicaid director hey good morning Lori McDonald DHS
Speaker 20
7:41
chief of staff thank you all real quickly be sure to pull your
microphones close as you can so we can all hear you clearly thank you good
Speaker 10
7:55
deal well this morning we are going to cover shared services at department of human services but first i just want to draw your attention we've we've given you all a draft comprehensive review outline and i just want to draw your attention that we've made two changes on page five and so if you have the document that says draft and preliminary in blue at the top on page five just a couple of technical edits we made to language uh
the first is hang on real quick colleagues that's the one that christy just
handed out to you today katie just handed out to you this morning it's a separate sheet it's been revised so it's not in your binder you look at the top draft and preliminary for discussion purposes only comprehensive review of arkansas dhs was just handed to you by
Speaker 10
8:38
katie this morning it's not in your binder okay thank you thank you so just two changes to page five under methods down below in the sub bullets under field visits we adjusted that did say recordings that we would have hotline recordings as part of our method we've we've gotten information from our legal
council that suggested that we we cannot release recordings but we will do a visit to the hotline operations at state police so that's one adjustment the second adjustment is we had listed field visits to residential facilities we've instead clarified that to be psychiatric residential treatment facilities because those are the medically necessary placements that are used in dcfs so those are the only two adjustments i want to make sure to call your attention to happy to take any questions otherwise we'll
Representative Cindy Crawford
Unverified
9:18
go forward any questions from anybody at this
point all right and secretary but before we even go any
further i just want to acknowledge how much i have enjoyed working with you how much we've enjoyed having you here in arkansas and the great strides that you've made in our state we are going to miss you deeply just wish you the best as you move forward thank you for all the hard work that you've done on our
Speaker 10
9:55
behalf thank you y'all are not allowed to make me cry first thing on a Monday morning thank you very much the feeling is mutual I have enjoyed tremendously the opportunity to be
here in Arkansas. It is a very bittersweet decision that we had to make on behalf of our family, but going to Kentucky to serve our family in a different way. And we have an amazing team at DHS, as you all well know, who will continue to do the good work and the transformational things that we have underway, especially with this committee. So we thank you for the chance to share it with you. So thank you all. And with that, I'm going to jump into shared services. This is probably the best kept secret at Department of Human services. Our shared services department has core business functions of the agency and it is behind
the scenes. This is the work that gets done to a transactional level that I think you are probably going to be a little bit surprised about if you have not seen some of the shared services work. So our shared services office combines, it's within the office of the secretary, but it includes secretary's office, our office of chief counsel, which includes our office of administrative hearings, which has a very heavy caseload, office of communications and community engagement, Office of Finance, Office of Human Resources, Office of Information Technology, Office of Legislative and Intergovernmental Affairs, Office of Policy and Rules, Office of Procurement, Office of Payment Integrity, and Office of Security and Compliance.
And the funding for all of these back-of-house functions comes from a cost allocation plan, revenue sources that include general revenue, federal funds, and other federal funding, other federal and other funding, as determined by that cost allocation plan. So the cost is spread out across the different divisions according to the services that are needed to be rendered for
Speaker 37
11:38
each division. So we followed a consolidated agency approach to the Office of Chief
Speaker 10
11:44
Counsel and Office of Appeals and Hearings that served multiple departmental divisions.
But we then expanded that approach in 2016. We were the first agency to undergo that business reorganization. Of course, that time predated my time here in Arkansas. I first got here in 2020, and it had already happened, but it was a lot of the changes and adjustments were still underway. It has been, everything has been brought together into the same shared services office. And along those lines, since 2016, we have downsized in our number of staff. So we currently have filled positions as 500, I think that's 11, and 688 available positions total.
But we've continued to streamline, find efficiencies, and find ways that we can do the back-of-house operations in a more efficient way. And if at any point my colleagues want to jump in here and provide any context, I would ask that they feel free to do so. So I'm going to go through these quickly because there's a lot of information, especially on this slide. But please feel free to stop me, ask questions as we go. We are the second largest governmental law firm in the state, the first being the AG's office. That being said, we have legal, investigative, and state fair hearing services.
It is part of shared service. DHS gets legal support from OCC across all of its divisions, and that includes our different units, including litigation, which is exactly what it says it is. They actually litigate court proceedings for us. We have a regulatory unit with division-specific attorneys. They research all agency division programs. They provide us policy guidance, including on Medicaid and CHIP, SNAP, TANF, T, all the programs that we have. We have that regulatory unit.
They provide legal consultation and advice. They also participate in some of our litigation activities. They do all of our HIPAA regulations that are specific to Medicaid. And we have clerical staff who support that, and we have staff travel that is a part of our regulatory activities. We have county legal operations. This is a litigation division that is actually within OCC providing legal services to DHS in child welfare and adult protective services. These attorneys represent us, DHS, independency and neglect cases, and adult maltreatment, and also public guardian proceedings.
And then we also have administrative hearings where we have individuals who may be placed on our maltreatment registry. We have the Office of Public Guardian and County Legal Operations Administration. This unit is charged with providing guardianship services to adults who are incapacitated or aren't able to make decisions or have no friends or family willing to serve in that capacity. Those duties can range from arranging placement, which we've had a lot of activity this past year in helping arrange placement for wards of the state, visiting and preparing annual court documentation that's needed for people who are deemed wards of the state.
We also have the Office of Procurement and Contract Attorneys. These attorneys provide legal research and representation for all of our procurement programs and activities. They examine our contracts. They do extensive work, again, behind the scenes. And then we have our Human Resources Council, and they provide legal representations in any litigation that comes about as part of HR activities, disciplinary actions. They review policies, and they provide legal advice and counsel to all of our divisions about human resource actions that either have been taken or may need to be taken.
I'll pause there for a moment any questions
on OCC legal okay I just want just want to step back into your trend and downsizing graph as far as positions available to positions filled is there an expectation like what are these positions that we're we're not feeling that we have on the books that we we budget for that are those different departments that just randomly transition is the trend to
Representative Cindy Crawford
Unverified
15:46
start to match those numbers so i think i think the answer is a
Speaker 13
15:58
little bit of both and i'll ask deputy secretary eubanks to speak specifically to that yeah
thank you for your question so over the last period of time since 2016 we've actually turn back a number of these positions and these positions that you see here is the 688 continue to be authorized in our appropriation act however currently we don't have plans to fill all or many
of those positions so we are continuing to hover right around this 511 number we are backfilling current positions so for instance if we have a county legal operations attorney who maybe is in the union county office and he or she resign then we are asking to backfill that position but for the most part we're currently on a one-in-one-out basis we do have just a few positions that have been vacant maybe six months or longer due to covid and other things when we had staff leave
And we have just a small number of those that we continue may be hard to fill positions. So, for instance, attorney positions have been hard to fill. Accountants have been hard to fill for us. IT positions have been hard to fill. And we're hopeful that the pay plan that's coming in July will help us to recruit and retain some of those highly specialized positions that we've been unable to fill. So, like, for instance, in our Division of Medical Services, we had a data
analyst that we've had vacant for about two years, and we just identified a good candidate, and we're onboarding that person currently.
So I would say, for the most part, we won't be ever getting back up in this high range that you see here on the slide today.
thank you so so just to look at the graph it looks like we're staying all the way back from 2017 we're consistently staying about 120 positions above so we're not asking for new but
you say we're turning back those positions but we're keeping them on the
books so strategically we have been turning back positions to opm which takes them off of our books permanently um but i can get you the trend data of what we've turned back over the last few periods if that's helpful for
Speaker 47
18:17
this committee yeah i guess that'd be helpful to see
like at what at what target date are we going to turn back enough positions to get to a you know 10 percent of positions not filled versus a 20 25 percent positions not filled yes i'll be happy to get
Senator Fredrick J. Love
Unverified
18:36
that data for you thank you thank you any other questions before we move forward sender love thank you madam chair now along the lines of senator Bryant so so miss you banks let me ask you this then are some of these positions do we just necessarily have to have some of the 688 in order to in case something
Speaker 61
19:05
comes up I mean, like, name some of these positions that may not always be filled, but we need them on an as-need basis, I guess.
Yes, so that's a good question, so thank you for that. So you may recall several years ago when we brought the juvenile detention centers back online, right? We had a private contractor at that time. We had issues in procurement, and then we took over those day-to-day operations as state employees. So part of that, DYS did, but also part of that, our Office of Procurement and Contracts needed to
take on because we started sourcing the food directly. We started sourcing procurement people to help them with all things they
needed, like uniforms and soap for the kids and things like that.
So during that period, we did have a slight uptick in some staffing. And so you're exactly right. We have kind of two instances. we do have some high turnover in positions in lower level positions maybe in what we call a grants analyst position grants analyst position under the current pay plan is a gs06 and we use those as beginning or entry level positions in both our office of finance as well as our office of procurement and a couple of other places and so we do need a few vacant continuously vacant
positions so that we can have those and while we're pursuing a one-in-one-out model of back filling we do need some room in there in case we have unexpected issues so that would be another place that I would say we have just a few extra positions that may not be always filled but we do keep on
Speaker 54
20:48
hand in case we have an unexpected issue come up okay all right thank you thank you anyone
Speaker 66
21:00
you all right okay so a little bit more just about
Speaker 10
21:09
office of chief counsel again second largest governmental law firm in the state we have four different teams they're organized into child welfare adult protective services public and public guardian administrative hearings and appeals and each team focuses on the areas within that subject matter on litigation, and they have field attorneys who work very closely with DHS central office, and they manage legal staff. They coordinate with area and central office to meet goals. They are proficient in Arkansas law, DHS policy, and court procedures.
And then the Office of Public Guardian also receives applications from across the state regarding people who may need our guardianship services. They serve some of the most vulnerable people in our state. They have a deputy public guardian who is assigned to our Division of Developmental Disability Services, who also works closely with those partners to identify and assist clients in our HDCs or in the DDS population who need additional services, including guardianship. Sometimes we have DCFS kids who will age out of care who need Office of Public Guardianship
assistance after they complete foster care so there's just a there's a great deal of work that goes on that we wanted to represent here that's within the second largest law governmental law firm in the state and just to give you an idea of caseloads county legal operations child welfare cases between 2022 to 25 so you can see that you know we've consistently kept a significant number of cases.
Speaker 37
22:44
As of December of this past year, we had 2,660. Oh, I'm sorry. 2,284. I was reading the
wrong direction. So 2,284, which is slightly down from
Speaker 10
23:01
previously in 2022, we had 2,660. And then our adult protective services are represented down at the bottom. Those are not as, we don't have as many of those but you know again those can be very complex and complicated with relatives and with just different properties and things of that nature so we have 507 back in
Speaker 37
23:21
December of 2022 and today or as of 2024 we had 480. So as of June 1st so this is fresh data 2025 our
Speaker 10
23:34
CLO attorneys were managing more than 3,800 active cases, and they participated in 900 hearings just during the month of May alone. So, I mean, they are constantly out and in courtrooms and traveling. When I go, when I've been on my county office visits, our team has gone out. The county legal office attorneys are generally not in their offices. They're usually in court cases, in courtrooms across the state. And then a little bit more, a deeper dive on the appeals and hearings. They hold hearings and issues, and they issue written decisions regarding appeals
for Medicaid, SNAP, adult and child maltreatment, and internal employee grievances. So as of April of 2025, they had a total of 3,005 open administrative hearing cases. So that's, again, a significant caseload that they carry on a regular basis. And, you know, down below just some of the initiatives, they review all program decision and correspondence templates to make sure that we're consistently giving the same information for decisions that are given by the division. They create templates and they map them to our docketing system. They do an online
library for training materials. They do training and cross-training within OAH to make sure that everyone is delivering consistent decisions. They implement hearing quality standards and metrics that are tied to the employee performance evaluations. They are currently focused on eliminating backlog of criminal pending or continued cases in our child maltreatment work, and they also integrate employee grievance records to the docketing system, and that's something that's ongoing, that's in process. Are we as a pop? We could take a couple of questions.
Senator Dan Sullivan
Unverified
25:12
Take a couple of questions. I'm with legal. Senator Sullivan. Thank you, Madam Chair. I'm sorry I'm a little bit behind on this, but I'm looking at procurement. So we have several laws that we passed on DEI and discrimination that are not a part of our, as far as I'm aware, not a part of our procurement process. So is it possible for us to sign a contract that does not have that clause in
there preventing companies from supporting dei and such is that a part of the process so we
Speaker 10
25:52
have we've worked on updating our policies in accordance with what has been passed and so i'll let deputy secretary
Speaker 34
25:59
eubanks speak to that specifically but we've
Senator Dan Sullivan
Unverified
26:02
worked on already updating to that okay so we are updated and all the contracts that we do have a clause in there that the companies we hire will not participate in DEI or that they will not violate federal executive orders in
Speaker 76
26:20
discrimination. We have updated language to be concurrent
with the laws that have been passed and we
Speaker 10
26:26
will go back and double-check to make sure but we can provide you some information
Senator Dan Sullivan
Unverified
26:29
on what that template says. Yeah and
I'd like to meet with someone afterwards to discuss that a little bit more. How would that affect contracts that were already signed for laws that go into effect in August? Is that impactful to them? I think we, I am not sure
Speaker 11
26:46
the answer to that. Okay, that'd be the question I'll ask after a while. Absolutely. Yes, we'll be glad to answer that
Representative Rick Beck
Unverified
26:53
offline. Representative Beck. Thank you Madam Chair. The and you may have to get back with me on this but but looking at your office of chief counsel and the workloads and you were saying all the Medicaid SNAP adult child maltreatment internal uh could you break those categories down in terms of the workload like it's the majority
related to medicaid or or what we will get that breakdown for you
Speaker 34
27:30
and bring it and send it back to uh caitlin to disperse or miss steel i'm sorry to disperse to the members yes sir thank you very
much. Senator Bryant. Thank you, Madam Chair. In that same line from Representative Beck, can you see how many are new people appealing the decision to not be able to receive those benefits versus people that are already in the system, or maybe you already know that answer,
of the 3,005 cases, how many are current recipients of these benefits that are appealing a decision within the system versus they are asking for the benefits and got denied we'll have to get that for you as
Representative Cindy Crawford
Unverified
28:10
well okay we have a mixture of both as you can imagine okay thank you representative eaves thank you
Representative Les D. Eaves
Unverified
28:20
madam chair i've got a we've got a member that's watching online unable to be here and he had a couple of questions and i'm going to ask for him his questions are about shared services so they're how effective is the shared services process
are needed actions delayed and are there differences in opinions on what actions to take on these issues I think he's just wanting to know is the process smooth since it's shared services is a different
Speaker 10
28:44
department sure so I can start that and then I'll ask our team to chime in on that so it is very efficient in my opinion and I'll give you one example being our HR and most of our we have shared services staff who are embedded with program offices so they get to know the work very closely, but they report to their shared services supervisors. Our HR team, as far
as their size, their efficiency, the transactions they handle during the Arkansas Forward Review that McKinsey undertook, they were recognized as being the ideal functional model comparable to any corporation in the state. So they held that up as a standard, and I'll defer to Deputy Secretary Eubanks for additional details
on that yeah I think what we have seen since we went to a more consolidated shared services model is that you see more consistency across the agency and more
efficiency and we have tried very hard to be consistent from division division and to secretary Putnam's point really especially around how we handle employees employee grievances you know the same around processing invoices I mean in all in all phases we put in standard operating procedures so what you will see now versus several years ago is that you don't get sort of one-off answers where it's like well if you're talking about DDS for example versus DCFS you don't get
a lot of we do it this way versus we do it that way and so that's very nice and I think both our public and our providers have more transparency and a better understanding on how the processes and procedures work. Senator Love.
Senator Fredrick J. Love
Unverified
30:45
thank you madam chair um i'm i'm backing up to the conversation that was just had with senator
sullivan in regards to this this di um this di piece and some of the things that he was saying so here's the thing if you're all going to have a conversation offline with dent with sullivan then i want to be a part of that conversation because i'm i'm not aware of some of the things that he was saying so it's information we can share back
yeah with the subcommittee would that that'd be good yes thank you thank you and with all these questions I'm asked them to get
Representative Rick Beck
Unverified
31:31
the information to Kate and to share it to the entire committee so thank you all very much representative Beck thank you madam chair you you you kind of got me interested you were talking about the efficiencies gained with the with the the shared services thing and as an engineer I always like numbers right so have we quantified
that as as to is there any like something reportable that we could actually
say hey it's 50 percent quicker or responding quicker or whatever yeah
unfortunately I don't have that tracking available i can't quantify like how many invoices we process on average part of the issue or part of the challenge was previous to 2016 we had very siloed operations that were spread
through the various programmatic divisions right so specific divisions would have their own finance teams they would have their own human resources teams and there was very little communication and very little tracking of those individually and so then we went to an incremental consolidation in some areas I happened to be the chief of procurement when that model was instituted so I
I did walk teams through coming in from various divisions and coming into a consolidated team. So I had a core baseline team that was already in our Office of Procurement, and then I added staff from various divisions. Again, there was no increase in staffing, and in fact, we did have some attrition through the next few months and years through that process. but I will say that overall it's become much more efficient
because we're able to better identify bottlenecks and we have a good overview of how the process is going and we do have standardized business processes as well as internal
Representative Rick Beck
Unverified
33:40
times when we see efficiency or something like that, We see, you know, the number that we use to capture that is like, well, we had 100 people doing this, and now we only have 75 people doing that.
But the thing I'm interested in doing is in terms of from a service, from the taxpayer's perspective, are we actually more responsive, quicker, or more responsive? any of that data like that that you could provide us and back through the committee i would be very helpful i certainly would be happy to go
back and talk with my various chiefs about that data i know we have done some of that data from time to time particularly we had a dashboard initiative several
years ago and we did some baselining at that point um so i would just need to go back and speak with those chiefs around how far that project went and what data is available but yes i will just say we have been very interested in getting the data and the metrics that's just been a big challenge for us given the way that the the overall data is kept and tracked but yes I agree thank you thank you
any other questions committee before we move on to finances okay please proceed secretary
Speaker 10
35:02
but absolutely and we will cover all of the different areas under shared services so there There's finance, procurement. We've got a list of ones to go. So our Office of Finance is comprised of centralized accounts, payable and receivable, support for purchasing and contracting, funds management, federal cost allocation, which is a very complicated process, state and federal reporting, which includes accounting and oversight for Arkansas's schedule of expenditures for federal awards, or CIFA, and annual comprehensive financial report.
just to give you an idea our budget is almost 11 billion with a b dollars it's total budget is pictured over there on the on the right hand side of the slide breaking it down federal funds account for 72 percent of that or approximately 7.8 billion state general revenue is 17 percent of that at 1.8 billion and then other revenue is 11 percent 1.2 almost 1.3 a little bit different picture the total funded budget which shows you the actual amount funded
is just over 11 billion and the breakdown is pretty similar to the other we do have metrics for our office of finance and i will not read all of these off to you but i do want to read a couple that just stand out about the the bulk of the work that gets done. So the general operations unit processed 54,675 invoices, including 3,574 statewide utility invoices for a grand total amount paid of $10.3 billion. So that's a lot
of invoices and transactions being processed. In the course of a year, we responded to the annual comprehensive financial report going over to the right, they responded to 230 annual auditor requests, accounted for 32,500 physical assets. There are over 100 bank accounts that are active with annual transactions of about $37.8 billion, again with a B, dollars. And then just looking at the middle part, the non-Medicaid federal draws of $1.5 billion in a total of 104,789 draw
Speaker 37
37:19
transactions that's where we put up the state share and draw down the federal share for 278 federal grant awards so in addition to Medicaid and the large programs that you think about we have 278 federal grant awards that are active and they're actively managed by our Office of Finance
Speaker 10
37:35
I will pause there for just a moment in case anyone has questions about these transactions Representative
Representative Rick Beck
Unverified
37:46
Beck, related to, you know, the federal funds is obviously a very large
chunk of this and that could change on us. Do
Speaker 114
37:53
you guys have any concerns about that or any projections maybe? Well, we certainly don't want
Speaker 10
38:01
to be in the position of projecting what the federal government is going to do because there's a lot of change being discussed until, I think, until we see actually comes through the Senate we you know we won't know exactly but we definitely are planning ahead for some changes to be made you know just in full
transparency and this is not anything new but we have seen some of our federal grants have been a little bit slower to be paid into our accounts but you know everything else is working as as it's supposed to and I will pause there for either Deputy Secretary Mann or
Speaker 17
38:42
Eubanks to step in with any additional information thank you for the question we
Speaker 118
38:47
have seen a few of our grants canceled in it in addition pull your microphone yeah closer thank you canceled in addition to new auditing and new guidance on how to claim those funds
so we have pivoted to be
Speaker 17
39:02
able to address that as far as federal changes happening As Secretary Putnam said, we are anxiously waiting to see the Senate's version of the bill and any potential outcome to that. So that's going to be July 4th, right? Now
Speaker 73
39:23
heard. That's what we've heard. Senator Bryant.
Thank you. Thank you. Just so I can make some notes of my paper. other revenue sources of 1.1 billion generally what what is the primary backing of that revenue the other revenue it comes from a
Speaker 10
39:48
number of different sources sometimes it's provider fees payments into into patient accounts so there's a variety we'd be happy to get you the list of what goes into other okay yeah i'm just curious if what what kind
reliability exists outside of just other general revenue from the state or the federal government like how often that fluctuates and I think just knowing that sources will help me
Speaker 112
40:14
understand it a little better sure and and it's you know they're
Speaker 10
40:19
pretty stable recurring types of sources but it's again provider assessments and fees and patient accounts
Senator Fredrick J. Love
Unverified
40:30
you senator love you've recognized put thank you madam chair just a quick question on the bank accounts the
37.8 billion that we have are those over the 100 accounts
Speaker 13
40:40
are those interest-bearing accounts so so some of those are and some of those are
not so thank you for the question some of these are commercial holding accounts where we fund the account and then push provider payments particularly to medicaid from those accounts a number of these accounts however are held for benefit of our patients particularly at our human development centers or at the state hospital or at the high school so it depends on the type of the bank
account whether it is interest-bearing or not interest-bearing but one of the things we've also begun to do with DFA is also invest funds into certificates of deposit so that we could
earn more off of our funds okay all right thank you so so where
Senator Fredrick J. Love
Unverified
41:35
is that account so would that be accounted in the budgetary are you accounting for those dollars in the when you see the
budget book it should be in there and i can definitely get you the specifics on that no i mean i don't need
Senator Fredrick J. Love
Unverified
41:52
any specifics i just need to know that that it is accounted for in the budget process yes
it is all right thank you any other questions members okay we'll
Speaker 10
42:07
move forward thank you secretary Putnam all right office of human resources so they managed the full employee lifecycle so from recruiting to hiring to onboarding training sometimes you know they help us with the performance evaluation process they take care of compensation and benefits and employee motivation and wellness we have
an average filled number of positions of 6,561 for this year. Our annual turnover, and we're continuing to work on this number, but our annual turnover is 55.48%. A very large number of those occur, you know, in our frontline staff and our direct care staff positions. We have a drop participation rate currently of 3.38%. And then over the course of the past year, we've had 19,229 employees trained and that's that's a combination of hard skills soft skills
new employee orientation new supervisor training we have required sexual harassment and active shooter training and then we have what's called take charge Thursday which are voluntary their weekly zoom presentations on staff development topics that vary from week to week this is a breakdown of our personnel. So we actually have a total of 8,231 authorized positions. We currently have, as of May 30th, 2025, we had 6,574 filled, 1,657 vacant. And that just shows the breakdown of what we have
Speaker 37
43:32
filled versus what we have vacant. This is one of the favorite slides of
Speaker 10
43:44
our group because it actually shows you where everybody lives at DHS. So we have our largest group at 28% is our developmental disability services team, and they represent 1,965 staff. Followed by one percentage point, DCFS is our second largest group in our employee distribution across the agency, 1,883
positions. And then the breakdown, I'm sorry, DCO, I said DCFS, DCO has 27%. In third place, we have our DCFS staff at 18%, and you can see the breakdown goes further with Division of Aging and Adult Services. We have our Division of Youth Services is 1%, Medicaid service, Medical Services, 1%, Secretary's Office is about 8%, and remember that does include shared services, and then we've got our Division, DPSQA, Division of Provider Services and Quality Assurance at 2%. I can just do a quick question back up there.
So I hate to say it, what does DCO stand for? I'm sorry, Division of County Operations. Okay. Yes. Not everybody in this committee is in public health, so I just want to make sure everybody. I try not to use
Speaker 10
44:51
acronyms, but please call me on it. Okay. And so I think the main point that we wanted you to see with this slide is that the majority, the vast majority of our staff are in direct care service. They're in direct frontline staff or they're direct care services in county offices or in our facilities. Anything to add to that from?
All right, I will move on to the Office of Information Technology then. So OIT, Office of Information Technology, they manage, coordinate, provide oversight, and they architect our information technology to support DHS's entire strategic objectives. They are responsible for all technology at DHS, and that's from desktop support to enterprise-wide solutions that we change or implement to make improvements in our services that we provide, both internally
and externally. So just to give you an idea of some of the priorities that they've recently been working on, they continuously engage our internal business clients, so our division folks and our staff, to make sure that they're providing customer service and achieving the project outcomes that we're seeking. They do have an enterprise level of care solution that reduces provider billing issues. We have expanded our data governance and our enterprise master client index so that we can get a full picture of the people we serve.
There is a reprocurement happening right now for our information support services. And then we work with DIS and divisions to join our Google Civvy Forms initiative, which basically is going to be a one point of entry for anyone who is seeking state services. Eventually, there will be a form that you fill out that creates a profile for you that then is recognized across any state platform, any state website that you enter. And then, you know, obviously, we update password standards and all the basic things that OIT does,
but they are very active in managing what we are doing to operate our different programs across the state. And I will, okay. And I can move on to Office of Procurement. So it does consist of a team of employees who are fully dedicated, they're full-time to traditional procurement and purchasing. They do our facility management. They do logistics support services for all agency users for the warehouse. They handle our printing, copying, and binding support services for DHS and for other state agencies.
We run a print shop at DHS that is utilized by other state agencies, and their work is phenomenal. So that is just something that we're happy to be able to do. but the quality is incredible, too. We do have a centralized mailroom at our Main Street complex, and they also conduct
fleet management for our vehicles. And I will pause there. Thank you.
Representative Cindy Crawford
Unverified
47:44
Representative Crawford, you're recognized. Is there an index somewhere in the book that shows us all the acronyms and what they're for?
We can do that. Thank you. Yes. All right, just to give you an idea of the volume, again, oh,
Representative Les D. Eaves
Unverified
48:14
I'm. Thank you. On the screen you had up there before about the printing and binding you do for other, I guess you said other agencies? Yes. Do you bill them for that? Yes. Okay.
Speaker 10
48:23
Thank you. So just, again, wanted to give you the picture of the sheer volume of work that happens in each of our shared services offices. But Office of Procurement in particular, this is for state fiscal year 2024. They developed 1,001 to 1,014 contract developments. Number of contract actions was 1,416. the commitment of the the total commitment amount was 722,706,283 and then number of purchase orders
almost 5,000 and you can just go down the list and see that we do a number of solicitations not including facilities in construction and so again we will get you the list of all the acronyms because this page does have a little bit of acronym soup on it but we have invitation for bid we have a request for i'm even proposals thank you i'm even drawing blanks on some of these um we do a lot of work off of the qualified vendor list which is with our state office of procurement and so it's just there's a lot going on with office of procurement and i know that
deputy secretary eubanks i probably did not do it justice if there's anything you want to call out specifically about procurement since she has
held that role and oversees it now no just want to re-emphasize that we do work very closely with the office of state procurement um we have for a number of years had delegation orders for instance to run these higher level and more expensive requests for a proposal and things of that nature that will be changing in the upcoming weeks and months and so we'll be working very closely with them as they take on a bigger
role doing some bids for state agencies and then we will retain a few projects that we're either in midstream on or we have specific expertise on but we we have always traditionally worked very closely with
Speaker 10
50:32
them all right i will move ahead to the office of communications and community engagement so um our it's called occe they do handle both internal and external communications media relations freedom of information or foia inquiries they handle the dhs website and all dhs
social media accounts so just to give you an idea of foias alone freedom of information act requests in calendar year 2024 they processed 1533 and i can tell you i i get the notifications when we get foias every morning at 7 a.m as soon as our staff comes in and starts looking at the emails I start getting notifications of these are the FOIA requests that have come in. It's a very active office, very responsive to public inquiry. Year-to-date, we've already processed 836,
so we're on track to have even more FOIA requests than we did last year. So they have done
Representative Cindy Crawford
Unverified
51:25
a lot of work in the past couple of years. Yes, ma'am. Yeah, let's get Senator
Bryant recognized. Thank you, Madam Chair. Just talking about the FOIA request, because I know Department of Education has had a lot of problems, I guess, at the local school level of out-of-state corporations basically making it a business of FOIA to see how they can better compete or how to better sell their product as a consultant for these lucrative contracts.
Do you know of these four-year requests how many are valid Arkansans actually wanting information about their case or their claim versus an out-of-state consultant group attempting to gain the system by understanding our RFP or RFQ processes? I'll be
happy to pull that information for you. I will just say that we have a standard response in place that if you are not a citizen of Arkansas, that we do not give you that information.
But if you have been engaged in an active or ongoing RFP and we're at the legal point that we can share that services back to you, then you are entitled to the information. But to your point, just these outside corporations who sort of
data mine our information, we typically send a template response that lets them know that under Arkansas law, you are not entitled
to that information. But we do track our statistics very finely, and I can get you that data.
Okay, yeah, I guess I should have went a step further to say they employ Arkansans to use their address and their ID to circumvent our state policy. So, okay, thank
Representative Cindy Crawford
Unverified
53:16
give you an idea of some of the work that communications and community engagement
Speaker 10
53:21
has been involved in. So, they have updated, we have an agency style guide. We want our communications across the board to be consistent so that people aren't getting different communications, so it's consistency.
They have done a weekly video series, which has been a new addition in the past couple of years, introducing different DHS leaders, doing some employee recognition, and focusing on special events. They've done a great job of really getting information out there, not just to our employees, but to our partners and community stakeholders. They have redefined the roles of a, we have a Medicaid team that's dedicated to communications, which is very important. We have a lot of complicated information that we have to get out to a lot of people,
but they cover the behavioral health developments and updates that we're working on with our crisis work, and they also have been updating on the Medicaid system of care reform that we've been under, that we've undertaken since we've been here. and then they also have website liaisons and we have monthly social media reports where we analyze best practices and we have people who are assigned to making sure that we're responding to any public inquiries or any concerns many times we have a facebook concern that gets logged and so we have different liaisons for each of our different program areas and their responsibility is to
make sure that they respond to or that they flag and escalate any issues that are communicated via social media on any of those platforms and I will pause there to see if anybody wants to add anything to that. All right that takes us to our Office of Legislative and Intergovernmental Affairs or OLEA is the acronym. This office was established in 2016 as part of the consolidation and the intent is to enhance coordination and responsiveness to constituents and members of
legislature. They do serve as the primary liaison between DHS, our legislative partners, and a very broad network of all of our community partners and stakeholders. And they help communicate the agency mission programs and initiatives, but most importantly, they respond to inquiries. And this is a very, very busy team. If you thought our FOIA inquiries were up there in number, if you take a look at the metrics, during calendar year 2024, we received 2,279 inquiries across the board from constituents from stakeholders and from legislators and we are on track uh to meet or beat that number
um probably beat it this year we are already at 1147 so anytime you all make an inquiry we route it through this office we make sure that it gets tracked we do have a tracking system and we make sure that that that issue gets closed down as as far as the answer has been provided and the issue has been resolved for that citizen or for the legislator involved and i will pause there i'm looking. Anything to add? We have our DHS Office of Policy and Rules, which is very behind the
scenes. They're responsible for promulgating all of our administrative rules. They maintain department policies, so any personnel policies or anything that changes internally. They have office management duties, and they also serve as our liaison to internal divisions at federal offices like the Center for Medicare and Medicaid Services. Office of Policy and Rules has two units. We have a non-Medicaid policy unit, and they're responsible for quality monitoring and oversight of all non-Medicaid, and then we have the Medicaid policy unit, and they're responsible
for working with divisions in DHS to research and develop policy on all of our Medicaid and CHIP programs and to make sure that we're in legal compliance with all of our Medicaid and policies at the federal and state level. We have our Office of Payment Integrity. This is where we look at potential fraud, waste, and abuse on the provider side. They are responsible for reviewing all Arkansas Medicaid providers and organizations that receive funding from DHS. They do evaluate performance standards. They make sure that we're complying with uniform
guidance, conduct financial-related reviews. They do identify loopholes in policy and internal controls to make sure that we can reduce the occurrence of fraud, waste, and abuse, and they're also responsible for recommendations on recoupment of funds or any improvements that we need to
Speaker 37
57:38
see. So during the period of April 1st, 2024 through March 31st of 25, Audit Coordination Unit completed 286
Speaker 10
57:46
audit reviews. There were 60 audits in audit assurance. They simplified our DHS audit requirements, and then we have a number of
payment-integrate activities, including investigating and reporting potential eligibility errors for our beneficiaries identified as prisoners, continuing developing a claims analysis process and identifying potential vendors who have issues there. We did work with the do not pay to identify claims that were potentially being paid for patients who have died. We are working with our Division of County Operations, again, to make corrections on that list. And then we also worked with an out-of-state hospital and identified claim billing errors that resulted in a substantial repayment of claims.
And so this is the office that when there's fraud, waste, or abuse, they work closely with whatever division it's happening in, and they work to make sure that any payment comes back to the state of Arkansas that is required. Office of Security and Compliance. They oversee safety and security. This is where our emergency response lives. So anytime that Adam is activating the statewide operations center, this is the unit that helps with that. They're responsible for fraud and internal affairs investigations. This is the beneficiary side.
The payment integrity was the provider side. This is on the beneficiary side. They investigate based on any suspected beneficiary fraud. That's where our audit coordinator is, and they also do compliance monitoring for the entire agency. And just to give you an idea, in the past year, the fraud unit completed 842 investigations. They found 156 intentional program violations, and that resulted in approximately $810,000 of overpayments to SNAP that are intended to be recouped.
We also had 25 internal affairs investigations. There were six responses to state emergencies that were required. And then I will tell you just for a little bit of color commentary on what the Office of Security and Compliance does. We have a vacant building across the street that we're dealing with right now. And routinely we have people who enter the building and the fires get started. And our Office of Security and Compliance is always the one that has to respond, work with the fire department. And they're working with the building owner to make sure that we have some security put into place that prevents that from happening.
So this this is an office that is active on the ground as well as behind the scenes looking at investigations for internal
Representative Cindy Crawford
Unverified
1:00:14
affairs and internal controls and That concludes the prepared information that we
have for you all So anyone have any further
Speaker 147
1:00:30
questions for DHS at this point Senator love Thank you.
Senator Fredrick J. Love
Unverified
1:00:35
Thank you, Madam Chair. Thank you all for the presentation. I just want to back up a couple of slides, too, because I saw that you had a number for the beneficiary side, but for the provider side, do we have a number of, number one, we looked at the intentionality of kind of, did they intend to defraud on the
on the on the recipient side but on the provider side do we look
Speaker 10
1:01:08
at that as well we do and we probably will get you
Senator Fredrick J. Love
Unverified
1:01:12
some numbers on that as well okay so you so you do have numbers on on who intentionally tried to defraud Medicaid from a provider standpoint and also the
Speaker 17
1:01:23
money that we are recouping yes sir and thank you for the question we do have the investigations on the provider side but that's also in partnership and collaboration with the Inspector General's Office for Office of Medicaid.
And so that is a combination of working with them. The intent to defraud is, I believe, a criminal code definition,
Speaker 151
1:01:44
which we will leave to the auditors. When we are investigating waste and abuse, it could lead to fraud or it shows a pattern. then we will work with our partners at omeg and medicaid fraud control unit in the attorney general's office they will take the lead on those investigations okay and then do but
Senator Fredrick J. Love
Unverified
1:02:02
we also have a number of of actual how much money was defraud and how much money is recovered do we have that
Speaker 17
1:02:10
number we can get that number um we usually track it from waste and abuse and then the other offices of omeg and medicaid fraud will they
Speaker 151
1:02:17
will determine the fraud numbers and they will disclose those Okay. All right. Thank you. Yeah, Representative, you
Representative Les D. Eaves
Unverified
1:02:32
should recognize. Thank you. Can you go back to the statement you made about
Representative Cindy Crawford
Unverified
1:02:37
the empty building, or did I misunderstand? No, you did not. There's an empty building across the street from the DHS main campus
Speaker 10
1:02:43
that is currently supposedly being developed, but we've struggled with security across the street from us. But we have a great security team in place on our campus that has been very active in helping patrol that area. So you're moving into that building?
Speaker 10
1:03:02
plan? Good question. We have had a lot of questions back and forth, and I'll ask Deputy Secretary Eubanks
to give some details on that. A private entity owns that building currently, and they are currently shopping redevelopment plans with a number of both private and public partnership entities.
So they are trying very hard to convert that building back into residential living space, some of which could potentially be low income or supported housing. However, that building has been empty since we moved into our new south building approximately 25 years ago. So we are not involved in that development.
However, we are the neighbor being impacted by the activity happening. renting it or it's just an empty building next door and that's
Representative Les D. Eaves
Unverified
1:03:50
what's causing the problems with
people breaking in yes correct okay and starting fires yes
and starting fires yes yes and so we recently removed we had a sky bridge we had a sky bridge that was attached to that because we we did occupy that building about 25 years ago and since then it's been held privately we did remove the sky bridge that connected our um dhs north building to that vacant just so we could
secure our building is the owner of the building
Representative Les D. Eaves
Unverified
1:04:26
doing anything to prevent some of these things that are
happening or so they have been involved we've done a number of phone calls with them and then there was recently an in-person meeting they do have plywood up if you've been to the downtown area recently they've put up plywood and they are trying to secure the building however um folks wanting to make entry into that building have been pretty tenacious so thank you
senator bryant recognized thank you madam chair just looking at the office of payment integrity of the audits performed is that
generally a scheduled audit does every provider get an annual audit or is it scheduled
biannually or what's the process for that so we're in compliance with the uniform guidance so the first audit reviews those are actually providers who meet a federal funding threshold and they contract for independent audits by outside cpa firms and then
we receive those by deadline and then we do another review or audit on those and then we have completed 60 audits by audit assurance and we have those on a cadence that's sort of round robin and then we we pick some providers who may be under the threshold or other issues that we want to take a look at primarily those are in our other program spaces not major medicaid but we do some targeted medicaid looks like for instance this do not pay example that's on here and other
places where we can do some initial research and then
we partner as deputy secretary man said with oig and others if there's something of note okay okay thank you uh-huh thank you
any other questions okay secretary putnam thank you for your uh presentation while you're up sorry representative uh beta you're recognized thank you madam
Representative Howard M. Beaty, Jr.
Unverified
1:06:29
chair i i guess my questions are since we're we're dealing with shared services and and that's been the discussion today
uh my question and and since shared services really touches every division within your organization um do you do any review or follow-up with those division heads on what they think as far as the job and the performance of shared services how it impacts their division and that that follow-up and that study with those divisions have you encountered any problems or concerns that could have a broad impact on on all divisions and and if so how are
Speaker 76
1:07:08
you dealing with those internally so i do there is regular discussion with division chiefs and there are regular
Speaker 10
1:07:16
meetings between the different pieces of shared services with the program areas but i will let deputy secretary eubanks answer you know there are instances where we have identified that there's a challenge hr would be an example and we've had to work through that so
Speaker 13
1:07:33
deputy secretary do you want to address that specifically so we've used different methods we have
included survey methods we have done weekly bi-weekly and monthly meetings with our division
clients we also for instance when i was in office of chief counsel many many years ago and we would send surveys out to judges and with other stakeholders and so we have a many different methods that we ask for feedback and reviews on productivity we also at one time had survey links on all of our shared services emails um frankly what we found is we just didn't get a lot of
feedback but certainly we are happy to always address that i will also say that like the human development centers because of some statutes and some other things they have um autonomy over some of their shared services and they work in close partnership with us but they they are you know semi-autonomous due to our state statutes in that area and we work very hard with them on best practices support and other issues but i will just say that our chiefs who work in the shared
services spaces are very engaged with our executive team members and we are daily colleagues with one another and certainly if issues come up around procurement finance any of those things it is our job to problem solve that right we really view our division directors as our clients right We're here to help back of house work very smoothly so that the hard work that we do out in the field with our day-to-day clients, whether that be eligibility, whether that be child welfare, whether that be with our human development centers, I'm freeing those divisions and those staffs up to give the very best personal service to our constituents and our citizens in Arkansas.
all so if I can get a bill paid if I can get a contract done if I can get a staff member hired and onboarded who is helpful for you and your division that's my
Representative Howard M. Beaty, Jr.
Unverified
1:09:46
ultimate goal well that's follow-up I just like that that that's good to hear I mean because that that's you hit on the key point is those other divisions are your clients and and they don't have a choice who they use they're kind of mandated and and limited to the staff that you have at shared services
so I would like to see some of those surveys or some of that information if there's been an area that's been problematic and what steps have been taken to correct that because a problem at central services could have an effect on across the board on all the divisions but but thank you for what you're doing appreciate the information that I've heard today absolutely and it can
Speaker 10
1:10:26
you're right have an impact and so we've also done some work i'm sorry madam chair may i we've also done some work to provide some more connection so for example we had the office of procurement annual
training last year and we went in and gave some specific examples of how procurement directly impacted some of our clients so that there's a connection to the frontline work that's being done so our shared services feels included in the mission which which they very much do so
Representative Jim Wooten
Unverified
1:11:00
thank you for that. Representative Wooten, you recognized? Thank you, Madam Chairman. I have two questions. One deals with the distribution of the cost of the operating of shared services. Is that spread
out among on a monthly basis or how do you handle that?
Yes, sir. We actually have a contractor who works with our state
staff in shared services to do what's called a cost allocation plan and we file that with all of our federal partners on a quarterly basis we also review and update that cost allocation plan on a quarterly basis i think it runs about seven to eight hundred pages because
it literally goes into every single activity that we do in the field and that's both in the division departments as well as shared services and then those costs get allocated across all of our eligible federal grants and supported with other funding as well as state general revenue and
we we true those up on a quarterly basis follow up if
Representative Jim Wooten
Unverified
1:12:08
i may yes sir okay is it prorated on
on the amount of work that's done for an agency or is it a set amount that it's it's prorated it's it's primarily prorated but we
do a number of different statistical studies as part of our
cap plan so some of it is based on the time or the activity and some of it is prorated so like For instance, our facility rent, our facility rent of our central office downtown is headcount across all of those employees who are housed at that unit and who is in what work department.
Representative Jim Wooten
Unverified
1:12:50
Okay. My last question is on developmental services, the facilities themselves, are you all aware of the problem that they face with staffing of nurses and adequate technicians? Yes, sir. We've been aware.
Speaker 76
1:13:09
We've taken a number of measures to try to address specifically
Speaker 10
1:13:15
nurses. We've worked very closely with TSS OPM on being able to increase bonuses and do some additional incentives for nurses.
I will ask Deputy Secretary Mann if she wants to speak more specifically. We're consistently hiring. Those are positions that we're always hiring for. We have seen a slight improvement in retention of those frontline staff, but Deputy Secretary Mann? Yes, thank
Speaker 17
1:13:44
you for the question. We have been working with TSS and OPM on different pay grids and different things that we can implement in anticipation of the pay plan coming later this summer. We have seen, I believe in the last quarter, a reduction in our contract use and an increase in our number of nurses being employed full time.
So we're hoping that that
Speaker 151
1:14:07
will continue and that we can reduce some reliance on those
Representative Jim Wooten
Unverified
1:14:13
nursing contracts. Yes, sir. Okay, so you're hiring permanent positions rather than outside contract nurses. And has that not created a problem with the amount of money that an agency pays a nurse to come in and perform what you need? Hasn't that created a problem with the help with the other nurses, permanent nurses?
Speaker 17
1:14:40
Yes, sir. we've been trying to address the morale we've also been trying to address the workload and the shifts by employing more full-time nurses and consistent nurses at the at the DDS facilities so that we don't have to rely on the contract nurses there are there are times when staffing ratios have to be met and it could be a last minute it could be a sickness it could be an illness that we do have to bring someone in at the last minute but we're also
Speaker 170
1:15:13
day thank you thank you madam sure colleagues
it's okay we're going to jump down to F on this on the agenda while secretary Putnam's at the table we can go over the reimbursement rates under cost of living and then we can move
Speaker 10
1:15:33
on to our discussion as a committee so absolutely that's F on our agenda yes so just a standard report as directed by section 15 of act 213 of 2022 i'm here to report to arkansas legislative council the status of our efforts regarding reimbursement rates under the living choices assisted living waiver
so i want to report that we have implemented act 198 of 2023 to establish cost reporting for all medicaid funded assisted living facilities our final cost report analysis and public comment responses were compiled last year the first one on march 4th of 2024 and we still have responses that you can see at the website included in the letter that you received in your packet. We previously reported that we received formal approval of the waiver amendment from CMS, which approved a new proposed rate of $86.73.
We presented that rate increase to public health last August 14th, received full ALC approval for that on August 23rd, and the new rate for assisted living facilities was implemented on September 1st, and that's now being used for all claims submissions. Annual cost reporting for this year, we are now conducting it annually, and so for this year, in accordance with Act 198 of 2023, we will share the results of this cost reporting cycle to the ALC. We opened this cost reporting period in January of 2025.
Data is being analyzed as we speak by our agency's contractor reviewer, Myers and Stauffer. As of this date, we received reports from all facilities, and as of the date of this letter. It was with the exception of four, and those four facilities that we had not received yet are listed in this letter. We do have an updated list for you. I believe we have now received it from all but one, and we will make sure to get you the name of the facility that has not yet provided its cost report, because we do have to receive all cost reports to complete that
process. They've all been contacted, and they committed to submitting those by Friday. Again, I believe we're still waiting on one and then finally as was requested in the May 31st 2024 meeting we do report that there have been no facility change of ownerships or closures for the month of April and I'm sorry I think that that April May that should have been May my apologies no change of ownerships or closures of all facilities for the month of May and we will continue to provide this information we typically text email and share that information as soon as
we get any notification of
Speaker 91
1:17:57
any pending closures or changes of ownership and that concludes our report
Representative Cindy Crawford
Unverified
1:18:04
for that thank you representative crawford we recognized thank you madam chair secretary putnam could you help me understand uh the 8673 per day where does what units i really don't understand. I have a constituent that's talking to me constantly about some homes that she has
that they only receive $34.57 a day. So can you tell me the difference and what those are? So I will start, but I'll ask Deputy
Speaker 10
1:18:41
Secretary Mann to step in. The $86.74 is the Medicaid rate for for services there are different pieces of payments that these facilities receive and deputy secretary mann can explain that to you much better than i can i will i will
Speaker 178
1:18:58
start and we will see i believe um what is happening there is the difference in
Speaker 17
1:19:04
a facility of an assisted living facility versus a residential care facility so in a residential care facility there is no additional payment for any anything associated with the facility the services that i believe your constituent is being paid for are for services to eligible medicaid beneficiaries and those are limited to personal care i'm more than happy to get get with you offline to discuss the the details but if i have the right entity in mind i believe they are
also in the process of converting to different types of services that
Speaker 151
1:19:43
could increase their reimbursement is that the
Representative Cindy Crawford
Unverified
1:19:46
16 bed as opposed to yes ma'am i believe it is yes i would love to meet with you online yes ma'am thank you
anyone else okay thank you secretary putnam for your day and we'll conclude that thank you thank you Okay, colleagues,
we're going to go back up to C, and we're going to let Senator English share with us some activities related
to workforce in that section of this committee.
Senator Jane English
Unverified
1:20:15
Good morning again. So I guess what we're going to do here with our two different things we have on our agenda is we're going to hold these on two different days. So all the things that have to do with DHS right now, we would hold on one day, and everything that has to do with the workforce side of it will hold on a separate day so we aren't confused. Does that make sense? Yes. So really, right now, what we have is an opportunity to begin to look at the modernizing and transforming the workforce development,
social services programs. As you can hear, DHS has an awful lot of stuff going on besides helping people find a job if they're under Medicaid, and there's some things going on in Congress right now, which I think we're all aware of, that will make a big difference, could make a big difference in our social and employment training programs down the road. So in August, we will hope to have something that begins to show us what is going to take place or
what's proposed. Hopefully that bill will go through. But one of the things that we know is that we have spent a lot of time and energy over the last few years working on our education reform. And so the education reform we have going on works right in tandem with how do we help to increase, make sure that people have the ability to leave some of these social services programs and move into the private sector or into a job that's going to pay them a living wage. So these are the things we'll be looking at over the next few months.
thank you senator English I just don't know if all of you on the committee know the senator English has decades of work with workforce services I think we're delighted to have her to lead in that discussion so let's look at section E of our agenda discussion of recommendations about the committee so each one of the members of the subcommittee are permitted to make recommendations if you have proposed recommendation to present to the subcommittee please email a short summary of your proposal to Kate Steele in our committee analysis remember these recommendations will not have full
confidentiality as both the chairs will see these recommendations so your proposed recommendations don't need to be detailed this is just a starting point for us to bring discussion so again this is a we want this to be a working group we're hoping to have our workforce group to be in maxi downstairs we can have a roundtable discussion I'm going to work that out so we can really as a group get together and bring some ideas for us so just know that we we encourage your input we want your input as this week as we move forward I also want to state
that we're going to give you guys an agenda our next so that you can bring her bring your great again remember bring your questions out to Kate so that DHS can be more prepared to have those questions answer for you when we come there I think we a better discussion if they know that what your questions or what your concerns are back in your district so get those questions to Kate so she forward those to DHS and they can be prepared to answer your questions that you're seeing out in your own specific district. So with that being said, does anybody have any questions or comments that I'd like to make at this point?
I really appreciate y'all coming Monday morning at 10 o'clock. It's an early time. I'm really excited to see the response to the committee. I was kind of concerned about this time of day, but it looks like it's worked out pretty well. There's lots of interest. It's great. All right. Seeing no further discussion, we'll consider this committee adjourned. Thank you.
Agenda
A. Call to Order
B. Consideration to Adopt the Comprehensive Review Timelines [Exhibit B]
C. Discussion of Proposed Activities Relating to Workforce and Social Services Reform Study [Exhibit C]
D. Department of Human Services (DHS) Update on Division of Shared Services [Exhibits D1- D2]
E. Discussion of Recommendations by Committee
F. Update on Reimbursement Rates Under the Living Choices Assisted Living Waiver Pursuant to Act 213 of 2022, Section 15 [Exhibit F]
G. Other Business
H. Adjournment
Documents
| Title | Type | Pages | Source |
|---|---|---|---|
| Agenda — ALC - HOSPITAL, MEDICAID, & DEVELOPMENTAL DISABILITIES STUDY SUBCOMMITTEE, Jun 16, 2025 | Agenda | 1 | Official source ↗ |
| Exhibit B- Tentative Timelines for Act 145 and Act 1004 | Exhibit | 3 | Official source ↗ |
| Exhibit C- Workforce Development | Exhibit | 2 needs OCR | Official source ↗ |
| Exhibit D1- Shared Services | Exhibit | 26 | Official source ↗ |
| Exhibit D2-DHS Draft Review Outline | Exhibit | 7 needs OCR | Official source ↗ |
| Exhibit F- Assisted Living Report May 2025 | Exhibit | 1 | Official source ↗ |
Speakers
Representative Mary Bentley Chair
Unverified
Speaker 10
Senator Joshua Bryant Chair
Unverified
Speaker 17
Speaker 20
Representative Cindy Crawford
Unverified
Speaker 37
Speaker 13
Speaker 47
Senator Fredrick J. Love
Unverified
Speaker 61
Speaker 54
Speaker 65
Speaker 66
Senator Dan Sullivan
Unverified
Speaker 34
Speaker 76
Speaker 11
Representative Rick Beck
Unverified
Representative Les D. Eaves
Unverified
Speaker 97
Speaker 114
Speaker 118
Speaker 88
Speaker 73
Speaker 112
Speaker 124
Speaker 145
Speaker 147
Speaker 151
Speaker 142
Representative Howard M. Beaty, Jr.
Unverified
Representative Jim Wooten
Unverified
Speaker 178
Speaker 170
Speaker 91
Senator Jane English
Unverified