Public Health, Welfare and Labor Committee - Senate and House
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Okay, if everybody can take your seats, gabbling in, thank y'all so much. Welcome, we're excited to have public health kickoff. I'm excited for everybody to be here. I'm excited to have Representative Ward-Law as my co-chair. do you have any comments no okay we're rolling um okay
i will need a motion to con uh to authorize
our the approval of special expenses incurred by the committees do i have a motion uh and second thank you all those in favor say aye and opposed eyes have it motion passes uh item c uh we need a motion to approve the minutes of the last meeting motion second all those in favor say aye and And opposed, eyes have it. Thank you. Moving to item D. If you can come to the table, item D.
Oh, sorry, that one's pulled. E, Department of Human Services. DHS? Mr. Representative Warlaw.
So, on rule two, make
Representative Jeff Wardlaw
Unverified
7:56
a comment for the department for purposes, but I don't expect that to go to
council next week as well. So, being pulled means it's put off to June for council and public health.
Thank you. Question? Just one second. Let me wake up our thing. okay
Representative Jack Ladyman
Unverified
8:31
you're recognized uh so we're passing over this until the next meeting is that what i understood yes uh well you know this is 300 and some odd pages yes sir it's very detailed yes sir
is does this just cover one rule are they putting a bunch of stuff together here because it would
be much better if these were split
out to where we really had time to study them well part of the reason for the delay is
number one that and then I would recommend members also meeting directly with the department as well and represent a board law okay
all right thank you thank you madam chair any other questions about us pulling that rule okay
so you'll have time dig into it read it meet with the department make
phone calls to them I what we're discussing is that we probably will have a meeting just for this rule in June separately from the other meeting so we may have two meetings in June and and depending on scheduling if we have to kick this to July then we're
gonna have to kick it to July I mean we may have to I don't know we can check because i'm saying that but scheduling is going to be really really tough i know for me in june so um we'll just just play it by ear but in the meantime it is delayed and postponed to to either june or july uh okay e if you'll just state your names for the record you're
Representative Aaron Pilkington
Unverified
10:12
recognized we're this i'm nil smith i'm a deputy director for the division of medical services at dhs
Representative Aaron Pilkington
Unverified
10:23
dhs so my understanding we're skipping over the medicaid administrative reconsideration and appeals or do you want to present it um are
Speaker 28
10:37
we skipping you can present it okay so this is a provider manual change that does two things it extends the time that medicaid beneficiaries can appeal on an adverse action from 10 days to 35 days
if a beneficiary files an appeal this is the second thing if a beneficiary files an appeal it allows for the continuation of services until a decision has been made this does not apply to adverse eligibility decisions for individuals who are not enrolled in Medicaid, only enrolled Medicaid beneficiaries with an adverse action, such as losing eligibility or decrease in services. This change is needed to comply with federal regulations that prohibit us from terminating
or reducing services if the beneficiary files an appeal before the adverse action date, and we're required to continue services until a hearing decision is made. The fiscal impact is $40.7 million, six of which is state funding. We'll be happy to take any questions. Are there any
and they're in the past, do they appeal to the past or do they appeal directly to DHS?
Speaker 26
11:56
That appeal process for past members is separate from this process. they would appeal directly to
the past okay are there any additional questions on this rule all right seeing none without objection this rule is reviewed
Speaker 28
12:16
item F and so this is a provider manual change that introduces the use of a new form to help identify clients in hospice upon entry into hospice it allows us to
to ensure that certain codes that are included in the hospice rate are not billed separately. There are certain codes that are separate and these are included in the hospice rate. We wanna know as soon as the person enters hospice that they've entered hospice and that the provider can't bill those charges
Representative Aaron Pilkington
Unverified
12:46
separately. This has no fiscal impact. - All right, are there any
questions from the members of the committee on this rule?
Seeing none, thank you. This rule is reviewed and
Speaker 28
13:03
approved. This is a state plan amendment that our federal regulators CMS require. We're attesting to the fact that we're complying with the annual requirements of the Medicaid core set. You may know the core set is a series of performance measures to identify the percentage of beneficiaries receiving recommended services. for 2024 CMS required states to report some measures the these some of them had
been these had been previously voluntary for the states to report and we've been reporting most measures voluntarily but needed to add several that we had not previously reported there's a fiscal impact of 60 about $64,000 for the additional work to calculate those measures the state impact is 32,000 about 32,000. Okay. Are there any questions
from members of the committee on this rule? Seeing none, this rule is reviewed and approved.
Speaker 28
14:05
So the next rule provides new rates for specialized
formula and associated supplies needed for individuals who are tube fed. We've had problems with a lack of providers providing these the specialized formula and the and the materials which have resulted in children with being hospitalized for insufficient nutrition and we needed to increase the rates review the rates in light of the shortage of the providers and the
increased cost to produce the formula and the rate that we've selected is the lesser of the medicare rate or 80 of the blue cross blue shield rates in most cases the rate that we've been that we've set was based on the blue cross rate we are also adding two new codes for a bolus syringe and gravity bags these had been part of another kit another code we've carved these out and are allowing providers to bill those separately. Overall, there were increases
in the rates. There were some decreases and some increases, but overall it's a 22% increase in total expected spend, or $1.9 million, and about $555,000 of that is state funds. Okay, is this primarily inpatient, or is this inpatient and outpatient? it's inpatient
and outpatient it is okay all right any questions from members of the committee representative Bentley you're recognized for question thank you chairman thank you for being here today
Representative Mary Bentley
Unverified
15:45
um appreciate something we definitely need to
do are we looking at anything else that
sometimes there are other hurdles with this like prior authorization those kind of things that we looked at what other hurdles might be uh causing the lack of providers to be able to provide this formula to us if we had looked at anything else besides this which i'm glad that we're doing the rate but sometimes there are things like prior authorization has that been a hurdle do you know of any of the hurdles that we've got for our providers here in the state for this formula i
Representative Aaron Pilkington
Unverified
16:14
don't know that we have looked at other uh other items we've spent the majority of the of our focus on the rates because that was the one that was the area that um was most in need okay but if we
Representative Mary Bentley
Unverified
16:26
could i request that you guys look at that for us and see if prior authorization is a hurdle for these things as well because really you know for these small population in our state is this formula is extremely important for them to keep their and if we can keep them healthy then we'll keep them you know we'll save ourselves money in the long run if we can get this formula available to them so we can look at some other things that might be hurdles i would appreciate that and it will help us i
think in the long run so thank you will do thank you are there any additional questions all right seeing none item will stand reviewed
Speaker 28
16:59
all right h the the last rule is we are
adding to our provider manual two urgent care visits per year for clients with an assigned primary care provider they are currently required to have a pcp referral for those urgent care visits. This will allow them to have two urgent care visits per year without having to have a PCP referral. The other is we're allowing beneficiaries that that do not have an assigned PCP to have
four urgent care visits before a PCP is referral is required. This aligns with the allowable visits that a beneficiary can have for hospital affiliated walk-in clinics and the increased number of urgent visits from the from two which is are
Representative Aaron Pilkington
Unverified
17:51
those with a PCP versus four without a PCP is to allow the individuals to get a PCP assignment it allows them time to get a PCP assignment and this policy change allows beneficiaries to access urgent care rather than the emergency room when they
have medical needs outside regular business hours and this rule is generated just through in in-house policy change or
yes not from legislation that's right representative pilkington you're recognized for a question thank you um
Representative Aaron Pilkington
Unverified
18:23
i've got issues with this rule change um because what we've understood for a long time is the primary care provider is essentially the quarterback of care and what worries me is that essentially we're allowing people who choose not to have a primary care provider continue to choose not to have a primary
care provider and we're not essentially getting them into that larger system of having someone control their care or you know not control but uh help better manage their care i mean that it seems like this flies in the face of i think what the legislature has been doing the last you know decade trying to get more people to have an assigned pcp who is someone who can actually be the quarterback of their care so um can you kind of address those issues because i think i do not like this rule and i don't think we should review it and approve it and so maybe make me feel better about this because i think this goes against what we as a legislature have been trying to do for a
long time which is getting these beneficiaries to actually
have a primary care provider yes sir um we we agree we want to preserve the the bond between a patient and their pcp um we that's why we still require a pcp referral we don't want to shift care onto urgent care clinics um what we're trying to um do is to preserve that while we preserve that relationship um we recognize that if someone is needing care outside of business hours um they're they're being sent to the to the
er we don't want them to be going to the er we want them to be able to access an urgent care clinic um it's a fine balance i i i give you that but we i can assure you our pccm uh uh program manager is very sensitive to disrupting that relationship, and that is not our intent at all. It is to make sure that we're not sending someone who could be treated in an urgent care outside of business hours rather than an ER. So, but to
follow up on that, I mean, they can access an urgent care currently.
There's nothing that, like, would prevent them from access. It's just the referral and getting paid is the issue. But, I mean, wouldn't this be an incentive for them to make sure that they're getting a primary care provider if they realize that they're not getting paid? I mean, those – and plus, a lot of these urgent cares are not open during those hours, you know, 11 o'clock at night when those people are accessing that ER. So, I mean, I don't see how that really solves the problem because I think people are a lot of times accessing these urgent cares when they can. It's just an issue of getting paid. And I always thought the idea of doing it the way we currently do it is this creates an incentive for them to get that primary care provider so they're not in a situation where they're, you know, having to wait or, you know, things like that.
So can you, I mean, are we not de-incentivizing people to
get a primary care provider with this rule? I don't think we're de-incentivizing it. We're still requiring it if they need to see a specialist. Deanna, it's coming as well. We're not de-emphasizing it. I think we're just trying to allow for people to be able to see a medical professional that's not in the ER outside of normal business hours. They still have, if they go to a specialist, they still are going to be told you need to have a PCP before you can see this specialist.
So there are plenty of other, you have to get a referral from a PCP to see a specialist. No,
I understand that. I work in health care, but I just, once again, I don't think you're really addressing my concern about de-incentivizing.
Senator Breanne Davis
Unverified
21:58
try to follow up and address your concerns. Currently, urgent care clinics are not an active provider type with Medicaid. They can be if they're connected to a hospital.
So here we are trying to open up the access and move away from the ER when it's non-emergent care. That is the goal of doing this, working with some of the providers that we worked with to develop this rule. I understand your concern. We don't want them to not have a PCP and not have that regular ongoing care. But yet we are hearing about hospitals having concerns about overflow in their emergency rooms with non-emergent care.
Representative Aaron Pilkington
Unverified
22:41
Which hospitals? Is it the one that just recently bought
Senator Breanne Davis
Unverified
22:47
a large group of urgent care clinics? It could be. I don't really
be an interesting conversation offline. But no,
Representative Lee Johnson
Unverified
23:04
it could. Okay. Thank you. Representative Johnson, you're recognized
for questions. Hey, thank you. Good morning. I'm over here, yes. So it says in here that you have a hospital-affiliated walk-in or emergent clinic visits. So it says allow the total for urgent care, hospital-affiliated walk-in, or emergent clinic visits. How are you defining emergency clinic visit versus hospital-affiliated walk-in versus urgent care?
Representative Aaron Pilkington
Unverified
23:32
policy. I'd have to get with our team to figure out how they're defining those currently. The policy about the four visits just adds the urgent care clinic as it would a walk-in
Representative Lee Johnson
Unverified
23:46
that's not the way the summary reads. It's allowed a total of four urgent care hospital-affiliated walk-in or emergent clinic visits
or accommodation thereof before PCP referrals require. I mean, I have a little different take. I am supportive of this idea.
I just want to make sure I understand from the perspective of a hospital-based clinic or an emergency clinic, how are you defining those? Because for a lot of places in Arkansas, there are, just like we talk about health care deserts, there are urgent care deserts. There are a lot of places in Arkansas where there are no urgent cares. And if you're in rural Arkansas, you have access to an emergency department 24-7 in that small town. You don't have access to an urgent care. And so I'm sympathetic with the people that show up in the emergency room at times for what would be perceived non-emergent visits because what are you going to do
if you're a single mother who works 40 hours a week and your kid's sick at 6 o'clock in the evening and you're in rural Arkansas and the only thing that's open is the emergency department and you're an hour's drive from the nearest urgent care. So I don't think it's inappropriate necessarily for those people in those situations to come to those hospitals. Those are hospitals where a lot of times the emergency department volume in a day might be 20 visits or less in a 24-hour period. So you're paying a physician most of the time in these situations to be on call for 24 hours and maybe see 15 to 20 people in their whole 24-hour shift.
So you're not overburdening that provider by having someone show up with a relatively non-emergent situation to have them see that person. I just want to make sure the hospitals are getting paid for that and the providers are getting paid, right? so if they're showing up and we at 10 o'clock at night in a rural hospital in Arkansas are required to get a PCP referral before we see that person and that PCP even though they're supposed to be on call you can't get hold of them you can't get hold their office you can't get a referral what are we supposed to do are we supposed to not so I guess I'm just asking does this include
that situation are we accounting for this situation where we have people in rural Arkansas that can't get access to urgent care their only option is to go to their local hospital if they want to see someone after hours on the weekend we ought to create a mechanism to pay for that if
Senator Breanne Davis
Unverified
26:00
we're not yes sir um we agree and so i think that's why it has hospital affiliated walk-in or emergent care clinics so we want them to be able to be seen as closest to their home as possible and some of that is going to be an emergency room for a non-emergent care but
we're trying to also provide if if the emergency room is overflowing there's a way to go to an urgent care for a non-emergent visit I understand that's why
Representative Lee Johnson
Unverified
26:23
I'm asking the specific question first how are we defining emergent clinic is that an emergency department visit if it's not maybe it should be yeah let let us get back
Speaker 27
26:33
to you on on that I think we need to because I think if I mean
Representative Lee Johnson
Unverified
26:37
I think that's an important point I mean if the intent is to try to you know provide extra access for care because we're recognizing that it's difficult to get care after hours on the weekends
if the only option for some of these people in their community is their hospital and there's not an urgent care available they ought to be able to get four free passes at the ed just like they're getting four free passes at the urgent care if that's what we're expanding
Senator Breanne Davis
Unverified
27:02
to i just want to make sure that the definition includes that i'm gonna um and that is
our intent all right so let us let us clarify i'm gonna bust in here for a second uh representative i know this is more of a health services issue, but Erin Pilkington, you're chair of the Human Services
Subcommittee, and I will assign our senators as well to this, but I'm going to send, without objection, I'm going to send this rule to the Human Services Subcommittee. You're the chair of that, and it's probably more of a health services issue, but I can choose to send it
where i want so i'm going to kick this rule to that subcommittee and um we'll continue to ask questions about it
and i'll continue to recognize but i think i think we need to
have a little bit more in-depth discussion about
this um so without objection i'm going to send this rule to the human services subcommittee and just one second um and i'm going to read to you the senate members fred love you're going to be the chair of that subcommittee um senator penzo will serve on that senator flippo and senator hill you'll be on him human services on health health services subcommittee um represent senator payton you'll chair that with representative i
Senator Letting and Senator Love and Senator Penzo and Labor and Environment subcommittee will be Senator Hill, Senator Letting, Senator Flippo, and Senator Payton. So we're going to
go ahead and move this rule to that subcommittee. Y'all can figure out a time to meet and really go through this a little bit more in depth but I will continue to let
folks ask questions and I'm sorry to interrupt but you have still have the floor representative johnson if i inadvertently created
Representative Lee Johnson
Unverified
29:03
a new meeting for myself i withdraw my question what i said if i inadvertently created a new meeting for myself i will withdraw my questions no i have no further questions i mainly just want to make
that point and make sure we're clarifying what that means because i think it's important to recognize that there are subsets in our community where the only health care acts accessible is the emergency department and and that's okay like I mean I wish it wasn't that way but if that's the way it is in a rural area and this is the only place I would rather them come to the emergency department to be seen than sit at home and not be seen so
Senator Breanne Davis
Unverified
29:37
yes sir and we're happy to to work
with y'all on that because our intent was to open some access and then try to preserve and make sure they get that PCP referral and have that relationship so we can work through those definitions and the
operations of that with y'all okay uh represent i mean i'm sorry let's see senator love
Senator Fredrick J. Love
Unverified
30:00
and senator payton thank you madam chair i i just hold my question since we're we're taking it to that subcommittee i would just ask the dhs be prepared for any definitions and also uh to ensure because senator johnson asked an interesting question in regards to the
ER versus urgent care and I have very very different meaning of what he is saying so I think we need really need to be prepared to discuss that in depth so that all the members would understand exactly what we're trying to do because I thought we were just trying to open up the access here versus you know try to decipher is it urgent care and are we I mean is it emergency care and what we're trying to we're trying to steer away from the emergency room which is the most expensive
care and I'm just so please be prepared to discuss that okay yes sir would be
happy to be prepared for that senator payton thank you madam chair and
Senator John Payton
Unverified
31:00
I guess I won't be in the subcommittee so I'll go ahead and ask my question but it's a real simple one I mean I'm not in the medical profession but I am a patient and I mean I would assume that at the urgent care facilities we're talking about. There are licensed physicians and advanced practice
registered nurses. And so, I mean, I understand we want to force a relationship, maybe according to Representative Pilkington with a primary care physician, but these, this referral process can really slow down medical care and that can have adverse effects. I currently have an employee that is suffering greatly at home, waiting two weeks to see a urologist and has already visited the emergency room twice because he can't get in.
I mean, that's the referral process from a patient's view. And I think we should be evaluating whether or not the urgent care clinic is capable of diagnosing and treating more than we worry about how the how the patient got there and whether they were referred or not but anyway y'all take care of it in the subcommittee and we'll see what comes back representative
rose to recognize her question thank you
Representative Ryan A. Rose
Unverified
32:22
madam chair thank you for attending today's meeting and for bringing this
before us along the same thought process that representative johnson brought up just in the definitions of the whether you know how are we incorporating or are we incorporating emergent care as opposed to just urgent care i see that there's no fiscal impact which i was just curious how we got there but i'll save that for a subcommittee meeting what i would like is as you before that takes place as you set your definitions or as you clarify your definitions
I would think that you'd need to reevaluate, um, that fiscal impact, because if this does involve emergent care, uh, we'd need to see if there was any cost associated there. If it doesn't, then maybe you don't have to, but I would think you need to take that in consideration if the definition isn't clear, uh, I guess more of a statement, but wouldn't you agree? Or would you be able to, to, uh, accommodate that for that next time we get together
Senator Breanne Davis
Unverified
33:24
on this? Um, yes, we can review the fiscal impact I think part of our reasoning when we were preparing the rule is
we were trying to open access therefore there would be no fiscal impact because it would be the same beneficiaries potentially going to an urgent care versus an emergency room was our was our goal but we will go back and look at it
again thank you thank you madam chair thank you yeah the other thing I would say on this is that making
sure you're clearly defining urgent care versus time of day there's a lot of primary care physicians that are open that have clinics
that are incentivized to provide same-day appointments we've done all of that so we just need to make sure that we're not just you know I guess again I think we've got to make sure We're being real clear about what has been brought up, but I also know that we have dealt with patients. It's not fair for primary care physicians who deal with these patients that are the lowest paid
and generally very, very difficult patients to deal with not to be skipped out on just because it's not convenient for the patient because, well, it's a pretty day, And I took off work and to have a doctor's appointment, but it's a really pretty day. And so instead, I'm going to go shop, go hang out with my friends or whatever. That happens. And I don't want these primary care physicians who are doing their due diligence, taking care of our Medicaid patients at a very low pay to be, to have their legs cut out from underneath them.
I mean, I'm just going to be really frank with you about that. So, and particularly for rural parts of the state of Arkansas, you know, I am fine with us paying for access to care where it's appropriate and where it's already infrastructure is in place, I mean, to their points. So I just, for that purpose, I think just really looking at that is really, really important because understanding these patients and how they treat our primary care physicians sometimes is not appropriate.
And our primary care physicians and providers need to be treated well by our state and our program because many times and oftentimes our clients sometimes are not the best patients and they don't treat them very well. and they're not respectful of those primary care physicians and their times and their clinics and their practices and trying to make ends meet and pay overhead. So keep that all in mind, I think, as you're having that discussion.
And I appreciate that. I have one last question. On any of the federally mandated type changes or changes that we've made in any of these rules where we did have large fiscal impact, Was that all accounted for in our budget, particularly Rule F, which was pretty substantial? Was that fiscal impact already kind of planned for, so to speak, in our budget? I think $6 million was state share of that,
but it's about a $40 million fiscal impact.
Is that correct? But we're budgeted for all that, correct? Yes, ma'am, we are. We did
Senator Breanne Davis
Unverified
36:56
take those into account because the rules have been in preparation for several months. Okay, okay. I just wanted to make sure one
sprung on us at the last minute and,
you know. I understand. Perfect. Okay, thank you. All right, we're going to move on. I'm sorry, Representative Ladyman, you had a question. Thank you, Madam Chair.
Representative Jack Ladyman
Unverified
37:17
And this is more of a comment than a question, but something that I think you need to consider what Senator Urban is talking about. and also Representative Johnson, you know, Lee talked about the impact on rural areas, and he's absolutely 100% right about that. But say you live in a city, is this going to open the door? Because as some of us know, you know, people will use the emergency room as a PCP for convenience. So is this going to open a door where they're going to use their four just for convenience before they go get a PCP?
I mean, is that going to add two people going to the emergency room in these cities where, you know, in Jonesboro, we have two big hospitals. So they could go there and use that emergency room as a PCP. So I think that's something you need to just consider. If you open the door too wide, you know, people are going to go in that don't need to go in. Do you understand what I'm
Speaker 56
38:16
getting at? Yes, sir, I do. Go ahead. I was just going to say
Representative Jack Ladyman
Unverified
38:21
yes, sir. Well, I know that's difficult to address, but just there's a thought process.
Thank you. All right. Thank you. Any other questions
on this? Okay. Again, without objection, we're going to send this rule to the Human Services Subcommittee. I'll read the members again from the Senate. Senator Wallace and myself are ex-officio members of all the subcommittees. Okay. We'll move on to Item J. and i'll say as as item j folks are coming up we just need to make sure that you have this
meeting so that we can get for the next um so that we could try to plan for this to be at june alc
thank you got it perfect okay hello mr hill good morning just if you'll state your name for the record you're recognized morning madam
Speaker 90
39:29
division of aging and adult services this morning presenting to you a rule change the agency operates two maltreatment registries a
children's registry and an adult registry a few about a year and a half two years ago we made a we created a process on the adult registry side by which a person may request their name to be removed from the registry, which mirrors the process that we have on the children's registry side. In doing that, we omitted to include one caveat, which is what I'm presenting to you here this morning. When a person who qualifies to have their name removed from registry makes that application, presently that request is reviewed by a panel of persons that work strictly for
Department of Human Services. The adult registry has a pathway by which you can have your name placed on that registry by two entities outside of DHS. Well, one within DHS, but operates independently in certain circumstances from my division. That's the Office of Long-Term Care and then also the Attorney General's Office. And so the rule that I'm presenting to you this morning would make the change to allow that when that panel reviews requests for removal from the registry and that request originates with either the office of long-term care or the attorney
general's office that a representative from that originating entity would also be included in the review process with that madam chair happy to take questions sounds like common sense to me
any questions all right seeing none thank you this item stands reviewed thank you ma'am okay um other business representative bentley can you give us a report for the month of may hold
Representative Mary Bentley
Unverified
41:24
up representative you're recognized thank you so much chairman and again thank you for uh
starting the month of may as we've done the begin our month of may which is women's health month so we all know how important it is for us to improve the health of women across our state and in doing so we have so many eyes many on this committee know but very few out of our constituents know how many opportunities and how many folks we have out there to help them improve their health so we've launched a month of may here in the capital steps just let people know what we have available here across the state with the health department all the other agencies we have and with our um healthy moms healthy baby bill just so much to celebrate that day was a great turnout and so thank you for that and uh just an awesome turn i think we're going to grow it every year so
Hopefully, each year we can add more and more participation out there. So thank
you. Thank you. It was a great event on May 1st, month of May, stands for MOM. So it's Women's Health Month. So as y'all are out and about promoting that would be great, encouraging people to go to their county health units for any type of checkup, prenatals, get your mammogram scheduled, whatever. Okay, any other reports?
Any other business to come before the committee? All right, let me read these subcommittees
one more time. Senator Wallace and Senator Irvin will be ex-officios of the subcommittees for the
Senate. Again, Human Services Subcommittee is going to be chaired by Senator Fred Love, Senator Penzo, Senator Flippo, and Senator Hill. Health Services will be chaired by Senator Payton, Senator Ludding, Senator Love, and Senator Penzo. And then Labor and Environment will be chaired by Senator Hill, Senator Ludding, Senator Flippo, and Senator Payton.
And Ms. Steele is back with us. We're grateful. She's had a baby girl. Congratulations. Baby girl. She wasn't with us during the session, but she's been home taking care of this baby girl. We're so happy and proud for you. But we're glad to have you back, too. But your folks, in the meantime, did a fabulous job for us. so any other comments nothing all right guys well buckle up here we go thanks for coming today we're adjourned
Agenda
A. Call to Order
B. Consideration of a Motion to Authorize Chairs to Approve Special Expenses Incurred by the Committees
C. Consideration to Approve the December 13, 2024, Meeting Minutes [Exhibit C]
D. Department of Energy & Environment (E&E), Division of Environmental Quality, Review of Rule, Rule No. 2, Rule Establishing Water Quality Standards for Surface Waters of the State of Arkansas [Exhibit D]
E. Department of Human Services (DHS), Division of Medical Services, Review of Rule, Medicaid Administrative Reconsiderations and Appeals [Exhibit E]
F. DHS, Division of Medical Services, Review of Rule, Hospice Provider Manual Updates [Exhibit F]
G. DHS, Division of Medical Services, Review of Rule, Core Set Reporting Requirements [Exhibit G]
H. DHS, Division of Medical Services, Review of Rule, Specialized Formula and Associated Supplies Rate Change [Exhibit H]
I. DHS, Division of Medical Services, Review of Rule, Urgent Care Clinics [Exhibit I]
J. DHS, Division of Aging, Adult & Behavioral Services, Review of Rule, Policy and Procedure for Name Removal from Arkansas Adult Maltreatment Registry [Exhibit J]
K. Other Business
L. Adjournment
Documents
Speakers
Senator Missy Irvin Chair
Unverified
Representative Jeff Wardlaw
Unverified
Representative Jack Ladyman
Unverified
Representative Aaron Pilkington
Unverified
Speaker 26
Speaker 28
Speaker 27
Representative Mary Bentley
Unverified
Speaker 56
Senator Breanne Davis
Unverified
Speaker 31
Representative Lee Johnson
Unverified
Speaker 65
Senator Fredrick J. Love
Unverified
Senator John Payton
Unverified
Representative Ryan A. Rose
Unverified
Speaker 72
Speaker 89
Speaker 90