Public Health, Welfare and Labor Committee - Senate
Video
Transcript
1 document
Bills discussed (85)
| Bill | Title | Sponsor | Status |
|---|---|---|---|
|
SB444
Act 970
· 6 mentions in transcript, chapter, agenda
Matched: “Senate Bill 444 Kim Hammer, State Senator District 16. Uh, I'm gonna read t…”
|
TO AMEND THE MEDICAL ETHICS AND DIVERSITY ACT. | K. Hammer | Notification that SB444 is now Act 970 |
|
HB1255
Act 857
· 4 mentions in agenda, chapter, transcript
Matched: “…DEFINITION OF "PRACTICE OF DISPENSING HEARING INSTRUMENTS". HB1255 Wooldridge TO AMEND THE COVERAGE OF A CONTINUOUS GLUCOSE MO…”
|
TO AMEND THE COVERAGE OF A CONTINUOUS GLUCOSE MONITOR IN THE ARKANSAS MEDICAID PROGRAM. | Wooldridge | Notification that HB1255 is now Act 857 |
|
SB546
Act 935
· 4 mentions in transcript, agenda, chapter
Matched: “to present Senate Bill 546 1st, please. Sure, you recognized? Thank you. This is an ag…”
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TO AMEND THE LAW CONCERNING THE TRUST FUND CONTRIBUTION FEE FOR WATER PERMITS RELATED TO … | K. Hammer | Notification that SB546 is now Act 935 |
|
HB1004
· 2 mentions in chapter, agenda
Matched: “HB1004 Pilkington TO REQUIRE MEDICAID COVERAGE FOR POSTPARTUM MOTH…”
|
TO REQUIRE MEDICAID COVERAGE FOR POSTPARTUM MOTHERS FOR ONE YEAR AFTER GIVING BIRTH. | Pilkington | Died in Senate Committee at Sine Die adjournment. |
|
HB1131
Act 959
· 2 mentions in chapter, agenda
Matched: “HB1131 Pilkington TO AUTHORIZE AN ADVANCED PRACTICE REGISTERED NUR…”
|
TO AUTHORIZE AN ADVANCED PRACTICE REGISTERED NURSE TO DELEGATE CERTAIN TASKS TO MEDICAL ASSISTANTS AND … | Pilkington | Notification that HB1131 is now Act 959 |
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HB1171
Act 625
· 2 mentions in agenda, chapter
Matched: “…AIN TASKS TO MEDICAL ASSISTANTS AND OTHER UNLICENSED STAFF. HB1171 K. Moore TO MODIFY THE MEDICAID PROVIDER-LED ORGANIZED CARE…”
|
TO MODIFY THE MEDICAID PROVIDER-LED ORGANIZED CARE ACT; AND TO AUTHORIZE AN ABBREVIATED INDEPENDENT ASSESSMENT … | K. Moore | Notification that HB1171 is now Act 625 |
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HB1185
Act 799
· 2 mentions in agenda, chapter
Matched: “…RD OF EXAMINERS IN SPEECH-LANGUAGE PATHOLOGY AND AUDIOLOGY. HB1185 L. Johnson TO ADOPT THE DIETITIAN LICENSURE COMPACT IN ARKA…”
|
TO ADOPT THE DIETITIAN LICENSURE COMPACT IN ARKANSAS. | L. Johnson | Notification that HB1185 is now Act 799 |
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HB1186
Act 960
· 2 mentions in chapter, agenda
Matched: “HB1186 Vaught TO CREATE THE PAIN RELIEF PARITY ACT; AND TO REQUIRE…”
|
TO CREATE THE PAIN RELIEF PARITY ACT; AND TO REQUIRE PAIN RELIEF PARITY IN THE … | Vaught | Notification that HB1186 is now Act 960 |
|
HB1187
Act 858
· 2 mentions in chapter, agenda
Matched: “HB1187 Vaught TO AUTHORIZE A LICENSURE BY ENDORSEMENT FOR MARRIAGE…”
|
TO AUTHORIZE A LICENSURE BY ENDORSEMENT FOR MARRIAGE AND FAMILY THERAPISTS. | Vaught | Notification that HB1187 is now Act 858 |
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HB1218
· 2 mentions in chapter, agenda
Matched: “HB1218 J. Mayberry TO CREATE LICENSURE FOR THERAPEUTIC RECREATION…”
|
TO CREATE LICENSURE FOR THERAPEUTIC RECREATION SPECIALISTS; AND TO CREATE THE THERAPEUTIC RECREATION PRACTICE ACT. | J. Mayberry | Died in Senate Committee at Sine Die adjournment. |
|
HB1241
Act 568
· 2 mentions in agenda, chapter
Matched: “…ONTINUOUS GLUCOSE MONITOR IN THE ARKANSAS MEDICAID PROGRAM. HB1241 J. Mayberry TO ENSURE THAT THE ARKANSAS MEDICAID PROGRAM RE…”
|
TO ENSURE THAT THE ARKANSAS MEDICAID PROGRAM REIMBURSES FOR DENTAL AND ANESTHESIA COSTS FOR HIGH … | J. Mayberry | Notification that HB1241 is now Act 568 |
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HB1251
· 2 mentions in agenda, chapter
Matched: “…SION TO BE AN ADVISORY COUNCIL TO THE DEPARTMENT OF HEALTH. HB1251 L. Johnson TO ESTABLISH THE ARKANSAS ANESTHESIOLOGIST ASSIS…”
|
TO ESTABLISH THE ARKANSAS ANESTHESIOLOGIST ASSISTANT ACT; AND TO PROVIDE FOR LICENSURE OF ANESTHESIOLOGIST ASSISTANTS. | L. Johnson | Died in Senate Committee at Sine Die adjournment. |
|
HB1252
Act 965
· 2 mentions in chapter, agenda
Matched: “HB1252 L. Johnson TO ESTABLISH THE CERTIFIED COMMUNITY-BASED DOULA…”
|
TO ESTABLISH THE CERTIFIED COMMUNITY-BASED DOULA CERTIFICATION ACT; AND TO CERTIFY BIRTH AND POSTPARTUM DOULAS … | L. Johnson | Notification that HB1252 is now Act 965 |
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HB1285
Act 856
· 2 mentions in chapter, agenda
Matched: “HB1285 L. Johnson TO ESTABLISH AN EXEMPTION PROGRAM FOR AMBULANCE…”
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TO ESTABLISH AN EXEMPTION PROGRAM FOR AMBULANCE SERVICE'S OPERATORS FOR CERTAIN HEALTHCARE SERVICES. | L. Johnson | Notification that HB1285 is now Act 856 |
|
HB1403
· 2 mentions in agenda, chapter
Matched: “…NEFICIARIES ENROLLED IN A RISK-BASED PROVIDER ORGANIZATION. HB1403 Pilkington TO AMEND THE ARKANSAS HEALTH AND OPPORTUNITY FOR…”
|
TO AMEND THE ARKANSAS HEALTH AND OPPORTUNITY FOR ME ACT OF 2021 TO ALLOW NONHOSPITAL … | Pilkington | Died in Senate Committee at Sine Die adjournment. |
|
HB1428
Act 855
· 2 mentions in agenda, chapter
Matched: “…DIVIDUALS WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES. HB1428 Steimel TO AMEND THE LAW REGARDING PUBLIC LODGING; AND TO P…”
|
TO AMEND THE LAW REGARDING PUBLIC LODGING; AND TO PROVIDE A BED HEIGHT REQUIREMENT FOR … | Steimel | Notification that HB1428 is now Act 855 |
|
HB1429
Act 854
· 2 mentions in chapter, agenda
Matched: “HB1429 M. Shepherd TO INCREASE ACCESSIBILITY WHILE ENSURING QUALIT…”
|
TO INCREASE ACCESSIBILITY WHILE ENSURING QUALITY FOR CERTAIN FACILITIES PERFORMING MAMMOGRAPHY SERVICES; AND TO AMEND … | M. Shepherd | Notification that HB1429 is now Act 854 |
|
HB1439
Act 853
· 2 mentions in agenda, chapter
Matched: “…NONHOSPITAL ENTITIES TO BE COMMUNITY BRIDGE ORGANIZATIONS. HB1439 Ladyman TO REMOVE THE CERTIFICATION PROCESS OF THE DEPARTME…”
|
TO REMOVE THE CERTIFICATION PROCESS OF THE DEPARTMENT OF HUMAN SERVICES FROM LICENSURE AS A … | Ladyman | Notification that HB1439 is now Act 853 |
|
HB1440
Act 629
· 2 mentions in agenda, chapter
Matched: “…OF HUMAN SERVICES FROM LICENSURE AS A PRIVATE CARE AGENCY. HB1440 Bentley TO AMEND THE MASSAGE THERAPY ACT; AND TO ESTABLISH…”
|
TO AMEND THE MASSAGE THERAPY ACT; AND TO ESTABLISH REGISTRATION FOR MASSAGE THERAPY ESTABLISHMENTS. | Bentley | Notification that HB1440 is now Act 629 |
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HB1442
· 2 mentions in chapter, agenda
Matched: “HB1442 Achor TO SET RESTRICTIONS ON PHARMACY CONTRACTING AND CONFL…”
|
TO SET RESTRICTIONS ON PHARMACY CONTRACTING AND CONFLICTS OF INTEREST; AND TO ESTABLISH PHARMACEUTICAL PATIENT … | Achor | Died in Senate Committee at Sine Die adjournment. |
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HB1454
Act 674
· 2 mentions in agenda, chapter
Matched: “…ESTABLISH REGISTRATION FOR MASSAGE THERAPY ESTABLISHMENTS. HB1454 Bentley TO AMEND THE LAWS CONCERNING CRIMINAL HISTORY RECOR…”
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TO AMEND THE LAWS CONCERNING CRIMINAL HISTORY RECORDS CHECKS FOR EMPLOYEES OF SERVICE PROVIDERS; TO … | Bentley | Notification that HB1454 is now Act 674 |
|
HB1458
Act 851
· 2 mentions in chapter, agenda
Matched: “HB1458 L. Johnson TO AMEND THE DEFINITION OF "CREDENTIALING INFORM…”
|
TO AMEND THE DEFINITION OF "CREDENTIALING INFORMATION" WHEN THE ARKANSAS STATE MEDICAL BOARD IS PROVIDING … | L. Johnson | Notification that HB1458 is now Act 851 |
|
HB1471
Act 966
· 2 mentions in chapter, agenda
Matched: “HB1471 Wooldridge TO AMEND THE EXPIRATION DATE OF ALL LICENSES OF…”
|
TO AMEND THE EXPIRATION DATE OF ALL LICENSES OF THE BOARD OF EXAMINERS IN SPEECH-LANGUAGE … | Wooldridge | Notification that HB1471 is now Act 966 |
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HB1537
Act 850
· 2 mentions in agenda, chapter
Matched: “…RD IS PROVIDING INFORMATION TO CREDENTIALING ORGANIZATIONS. HB1537 Ladyman TO REPEAL THE LOCATION ACT FOR COMMUNITY HOMES FOR…”
|
TO REPEAL THE LOCATION ACT FOR COMMUNITY HOMES FOR INDIVIDUALS WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES. | Ladyman | Notification that HB1537 is now Act 850 |
|
HB1543
Act 631
· 2 mentions in agenda, chapter
Matched: “…O A PERSON WHO IS UNDER EIGHTEEN YEARS OF AGE. Page 4 of 5 HB1543 Underwood TO ESTABLISH THE WORKFORCE EXPERIENCE OPPORTUNITI…”
|
TO ESTABLISH THE WORKFORCE EXPERIENCE OPPORTUNITIES ACT OF 2025. | Underwood | Notification that HB1543 is now Act 631 |
|
HB1559
Act 632
· 2 mentions in chapter, agenda
Matched: “HB1559 McGrew TO REQUIRE THE DEPARTMENT OF HUMAN SERVICES TO SEEK…”
|
TO REQUIRE THE DEPARTMENT OF HUMAN SERVICES TO SEEK A WAIVER TO THE ARKANSAS MEDICAID … | McGrew | Notification that HB1559 is now Act 632 |
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HB1576
· 2 mentions in chapter, agenda
Matched: “HB1576 Lundstrum TO PROHIBIT A SOLID WASTE LANDFILL TO BE PLACED O…”
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TO PROHIBIT A SOLID WASTE LANDFILL TO BE PLACED OVER A KARST TOPOGRAPHY. | Lundstrum | Died in Senate Committee at Sine Die adjournment. |
|
HB1582
Act 708
· 2 mentions in agenda, chapter
Matched: “…ESTABLISH THE SOCIAL WORK LICENSURE COMPACT IN THIS STATE. HB1582 McAlindon TO REQUIRE CERTAIN ACTIONS AND ENCOURAGE CERTAIN…”
|
TO REQUIRE CERTAIN ACTIONS AND ENCOURAGE CERTAIN ACTIONS FOR AN INDIVIDUAL TO BE ELIGIBLE FOR … | McAlindon | Notification that HB1582 is now Act 708 |
|
HB1585
Act 849
· 2 mentions in agenda, chapter
Matched: “…ULAS IN THIS STATE TO IMPROVE MATERNAL AND INFANT OUTCOMES. HB1585 L. Johnson TO PROVIDE AN EXCEPTION FROM LICENSURE AS A HOME…”
|
TO PROVIDE AN EXCEPTION FROM LICENSURE AS A HOME HEALTHCARE SERVICE TO AN ENTITY THAT … | L. Johnson | Notification that HB1585 is now Act 849 |
|
HB1622
Act 635
· 2 mentions in agenda, chapter
Matched: “…FOR BENEFITS UNDER THE DIVISION OF WORKFORCE SERVICES LAW. HB1622 Gramlich TO AMEND THE MEDICAID FAIRNESS ACT; TO MODIFY THE…”
|
TO AMEND THE MEDICAID FAIRNESS ACT; TO MODIFY THE DEFINITION OF "ADVERSE DECISION" UNDER THE … | Gramlich | Notification that HB1622 is now Act 635 |
|
HB1677
Act 637
· 2 mentions in agenda, chapter
Matched: “…ICENSURE BY ENDORSEMENT FOR MARRIAGE AND FAMILY THERAPISTS. HB1677 Bentley TO AUTHORIZE ALCOHOL AND DRUG ABUSE TREATMENT PROGR…”
|
TO AUTHORIZE ALCOHOL AND DRUG ABUSE TREATMENT PROGRAMS TO MAINTAIN EMERGENCY MEDICATION KITS. | Bentley | Notification that HB1677 is now Act 637 |
|
HB1679
Act 861
· 2 mentions in agenda, chapter
Matched: “…AND ANESTHESIA COSTS FOR HIGH COMPLEXITY ORAL HEALTH CARE. HB1679 M. Brown TO AMEND THE REVISED ARKANSAS ANATOMICAL GIFT ACT;…”
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TO AMEND THE REVISED ARKANSAS ANATOMICAL GIFT ACT; TO ALLOW CERTAIN CLASSES OF PERSONS TO … | M. Brown | Notification that HB1679 is now Act 861 |
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HB1712
Act 639
· 2 mentions in agenda, chapter
Matched: “…HERAPY SERVICES THAT ARE NOT REIMBURSED BY MEDICARE PART A. HB1712 Joey Carr TO ESTABLISH THE SOCIAL WORK LICENSURE COMPACT IN…”
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TO ESTABLISH THE SOCIAL WORK LICENSURE COMPACT IN THIS STATE. | Joey Carr | Notification that HB1712 is now Act 639 |
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HB1734
Act 862
· 2 mentions in chapter, agenda
Matched: “HB1734 Childress TO AMEND THE LAW CONCERNING DEATH CERTIFICATES; A…”
|
TO AMEND THE LAW CONCERNING DEATH CERTIFICATES; AND TO CLARIFY THE MEDICAL PROFESSIONALS WHO MAY … | Childress | Notification that HB1734 is now Act 862 |
|
HB1751
Act 640
· 2 mentions in agenda, chapter
Matched: “…E TREATMENT PROGRAMS TO MAINTAIN EMERGENCY MEDICATION KITS. HB1751 Underwood TO REQUIRE AN APPLICANT FOR TEMPORARY ASSISTANCE…”
|
TO REQUIRE AN APPLICANT FOR TEMPORARY ASSISTANCE FOR NEEDY FAMILIES PROGRAM BENEFITS TO ENGAGE IN … | Underwood | Notification that HB1751 is now Act 640 |
|
HB1758
Act 641
· 2 mentions in chapter, agenda
Matched: “HB1758 Gramlich TO AMEND THE LAW CONCERNING HEARING INSTRUMENT DIS…”
|
TO AMEND THE LAW CONCERNING HEARING INSTRUMENT DISPENSERS; AND TO AMEND THE DEFINITION OF "PRACTICE … | Gramlich | Notification that HB1758 is now Act 641 |
|
HB1767
Act 863
· 2 mentions in agenda, chapter
Matched: “…TABLISH THE WORKFORCE EXPERIENCE OPPORTUNITIES ACT OF 2025. HB1767 L. Johnson TO ABOLISH THE EMERGENCY MEDICAL SERVICES ADVISO…”
|
TO ABOLISH THE EMERGENCY MEDICAL SERVICES ADVISORY COUNCIL; AND TO CREATE THE EMERGENCY MEDICAL SERVICES … | L. Johnson | Notification that HB1767 is now Act 863 |
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HB1782
Act 642
· 2 mentions in agenda, chapter
Matched: “…TO REQUIRE CERTAIN REPORTING OF PROCUREMENT ORGANIZATIONS. HB1782 Hudson TO PROHIBIT OVER-THE-COUNTER DIET PILLS FROM BEING S…”
|
TO PROHIBIT OVER-THE-COUNTER DIET PILLS FROM BEING SOLD, TRANSFERRED, OR OTHERWISE FURNISHED TO A PERSON … | Hudson | Notification that HB1782 is now Act 642 |
|
HB1784
Act 864
· 2 mentions in agenda, chapter
Matched: “…SEARCH ACTIVITIES WHILE THE APPLICATION IS BEING PROCESSED. HB1784 Wardlaw TO MODIFY THE INFORMAL DISPUTE RESOLUTION PROCESS F…”
|
TO MODIFY THE INFORMAL DISPUTE RESOLUTION PROCESS FOR LONG-TERM CARE FACILITIES. | Wardlaw | Notification that HB1784 is now Act 864 |
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HB1801
Act 961
· 2 mentions in chapter, agenda
Matched: “HB1801 K. Moore TO AUTHORIZE AN OUTSOURCING FACILITY OF LEGEND DRU…”
|
TO AUTHORIZE AN OUTSOURCING FACILITY OF LEGEND DRUGS AND CONTROLLED SUBSTANCES THAT COMPOUNDS A PRODUCT … | K. Moore | Notification that HB1801 is now Act 961 |
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HB1817
Act 865
· 2 mentions in chapter, agenda
Matched: “HB1817 L. Johnson TO ESTABLISH ELIJAH'S LAW IN ARKANSAS; AND TO RE…”
|
TO ESTABLISH ELIJAH'S LAW IN ARKANSAS; AND TO REQUIRE THE DEPARTMENT OF HEALTH AND THE … | L. Johnson | Notification that HB1817 is now Act 865 |
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HB1840
Act 967
· 2 mentions in chapter, agenda
Matched: “HB1840 L. Johnson TO AMEND THE MEDICAID PROVIDER-LED ORGANIZED CAR…”
|
TO AMEND THE MEDICAID PROVIDER-LED ORGANIZED CARE ACT TO ENSURE THAT SEDATION DENTISTRY IS COVERED … | L. Johnson | Notification that HB1840 is now Act 967 |
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HB1841
Act 1021
· 2 mentions in chapter, agenda
Matched: “HB1841 L. Johnson TO CREATE THE ARKANSAS REVENUE INVESTMENT IN VIT…”
|
TO CREATE THE ARKANSAS REVENUE INVESTMENT IN VITAL EMS SYSTEMS (ARRIVES) ACT; AND TO CREATE … | L. Johnson | Notification that HB1841 is now Act 1021 |
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HCR1009
· 2 mentions in chapter, agenda
Matched: “HCR1009 Ladyman TO COMPLY WITH ARKANSAS ACTS 2023, NO. 259; TO REQU…”
|
TO COMPLY WITH ARKANSAS ACTS 2023, NO. 259; TO REQUEST FEDERAL FUNDING FOR THE NEXT … | Ladyman | Approved by the Governor |
|
SB121
Act 968
· 2 mentions in chapter, agenda
Matched: “SB121 C. Penzo TO AMEND THE AUTOMATIC OCCUPATIONAL LICENSURE FOR…”
|
TO AMEND THE AUTOMATIC OCCUPATIONAL LICENSURE FOR OUT-OF-STATE LICENSURE ACT; TO APPLY THE AUTOMATIC OCCUPATIONAL … | C. Penzo | Notification that SB121 is now Act 968 |
|
SB122
· 2 mentions in chapter, agenda
Matched: “SB122 C. Penzo TO AMEND THE AUTOMATIC OCCUPATIONAL LICENSURE FOR…”
|
TO AMEND THE AUTOMATIC OCCUPATIONAL LICENSURE FOR OUT-OF-STATE LICENSURE ACT; TO APPLY THE AUTOMATIC OCCUPATIONAL … | C. Penzo | Died on House Calendar at Sine Die adjournment. |
|
SB2
· 2 mentions in chapter, agenda
Matched: “SB2 C. Penzo TO REPEAL THE STATEWIDE FLUORIDATION PROGRAM; AND…”
|
TO REPEAL THE STATEWIDE FLUORIDATION PROGRAM; AND TO REMOVE THE MANDATE FOR WATER SYSTEMS TO … | C. Penzo | Died in House Committee at Sine Die adjournment. |
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SB217
Act 969
· 2 mentions in chapter, agenda
Matched: “SB217 C. Penzo TO REQUIRE THE DEPARTMENT OF HUMAN SERVICES TO REQ…”
|
TO REQUIRE THE DEPARTMENT OF HUMAN SERVICES TO REQUEST A WAIVER TO EXCLUDE CANDY AND … | C. Penzo | Notification that SB217 is now Act 969 |
|
SB225
· 2 mentions in chapter, agenda
Matched: “SB225 J. Scott TO REQUIRE THE ARKANSAS MEDICAID PROGRAM TO PROVID…”
|
TO REQUIRE THE ARKANSAS MEDICAID PROGRAM TO PROVIDE A CATEGORY FOR BENEFICIARIES WITH SICKLE CELL … | J. Scott | Died in Senate Committee at Sine Die adjournment. |
|
SB255
· 2 mentions in chapter, agenda
Matched: “SB255 C. Penzo TO AMEND THE DEFINITION OF "DRUG" WITHIN THE FOOD,…”
|
TO AMEND THE DEFINITION OF "DRUG" WITHIN THE FOOD, DRUG, AND COSMETIC ACT; AND TO … | C. Penzo | Died in House Committee at Sine Die adjournment. |
|
SB262
· 2 mentions in chapter, agenda
Matched: “SB262 C. Penzo TO AMEND THE CORPORATE PRACTICE OF MEDICINE DOCTRI…”
|
TO AMEND THE CORPORATE PRACTICE OF MEDICINE DOCTRINE; AND TO AUTHORIZE A LICENSED MEDICAL PROFESSIONAL … | C. Penzo | Died on House Calendar at Sine Die adjournment. |
|
SB269
· 2 mentions in chapter, agenda
Matched: “SB269 C. Penzo TO AMEND THE REQUIREMENTS REGARDING LOCATIONS FOR…”
|
TO AMEND THE REQUIREMENTS REGARDING LOCATIONS FOR AND GEOGRAPHIC AREAS OF A HOSPICE AGENCY. | C. Penzo | Died in Senate Committee at Sine Die adjournment. |
|
SB289
· 2 mentions in transcript
Matched: “…y the medical ethics and Diversity Act of 2021, that it was Senate Bill 289. Most medical research is not completed as part of the spec…”
|
TO CUT THE STATEWIDE SALES TAX RATE BY ONE-EIGHTH PERCENT TO REDUCE THE SURPLUS FUNDS … | J. Dotson | Died in Senate Committee at Sine Die adjournment. |
|
SB311
Act 772
· 2 mentions in chapter, agenda
Matched: “SB311 C. Penzo TO CREATE THE END ORGAN AND GENOMIC HARVESTING ACT…”
|
TO CREATE THE END ORGAN AND GENOMIC HARVESTING ACT; TO PROHIBIT COVERAGE OF CERTAIN HUMAN … | C. Penzo | Notification that SB311 is now Act 772 |
|
SB312
· 2 mentions in chapter, agenda
Matched: “SB312 Stone TO REMOVE THE MORATORIUM ON THE CONSTRUCTION OR ADDIT…”
|
TO REMOVE THE MORATORIUM ON THE CONSTRUCTION OR ADDITION OF ANY ADDITIONAL BEDS WITHIN PSYCHIATRIC … | Stone | Died in Senate Committee at Sine Die adjournment. |
|
SB347
Act 1025
· 2 mentions in agenda, chapter
Matched: “…FOR WAIVERS; AND TO PROVIDE FOR ENFORCEMENT AND PENALTIES. SB347 C. Penzo TO REQUIRE THE ARKANSAS MEDICAID PROGRAM TO INCREA…”
|
TO REQUIRE THE ARKANSAS MEDICAID PROGRAM TO INCREASE REIMBURSEMENT RATES FOR CERTAIN DENTAL SERVICES AND … | C. Penzo | Notification that SB347 is now Act 1025 |
|
SB497
Act 655
· 2 mentions in chapter, agenda
Matched: “SB497 D. Wallace TO REQUIRE THE CREATION OF A POSTER REGARDING VE…”
|
TO REQUIRE THE CREATION OF A POSTER REGARDING VETERANS' BENEFITS AND SERVICES; AND TO REQUIRE … | D. Wallace | Notification that SB497 is now Act 655 |
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SB507
· 2 mentions in chapter, agenda
Matched: “SB507 G. Leding TO REQUIRE THE ARKANSAS MEDICAID PROGRAM TO COVER…”
|
TO REQUIRE THE ARKANSAS MEDICAID PROGRAM TO COVER APPLIED BEHAVIOR ANALYSIS SERVICES FOR CERTAIN BENEFICIARIES. | G. Leding | Died in House Committee at Sine Die adjournment. |
|
SB532
· 2 mentions in agenda, chapter
Matched: “…TS RELATED TO NONMUNICIPAL DOMESTIC SEWAGE TREATMENT WORKS. SB532 Hester TO AMEND THE DEFINITION OF "SPECIALTY HOSPITAL" RELA…”
|
TO AMEND THE DEFINITION OF "SPECIALTY HOSPITAL" RELATING TO THE ASSESSMENT FEE ON HOSPITALS UNDER … | Hester | Died in Senate Committee at Sine Die adjournment. |
|
SB556
· 2 mentions in chapter, agenda
Matched: “SB556 M. Johnson TO PROTECT PUBLIC DRINKING WATER SOURCES; AND TO…”
|
TO PROTECT PUBLIC DRINKING WATER SOURCES; AND TO PROHIBIT SURFACE DISCHARGE OF WASTEWATER INTO A … | M. Johnson | Sine Die adjournment |
|
SB557
· 2 mentions in agenda, chapter
Matched: “…SMENT FEE ON HOSPITALS UNDER THE ARKANSAS MEDICAID PROGRAM. SB557 M. Johnson TO AMENDS LAW CONCERNING WATER PERMITS AND DISCH…”
|
TO AMENDS LAW CONCERNING WATER PERMITS AND DISCHARGE OF WASTEWATER; TO AUTHORIZE DENIALS OF APPLICANTS … | M. Johnson | Sine Die adjournment |
|
SB560
Act 740
· 2 mentions in chapter, agenda
Matched: “SB560 J. English TO DECREASE THE BASE CONTRIBUTION RATE; TO INCRE…”
|
TO DECREASE THE BASE CONTRIBUTION RATE; TO INCREASE THE ADMINISTRATIVE ASSESSMENT RATE; TO INCREASE FUNDING … | J. English | Notification that SB560 is now Act 740 |
|
SB576
Act 623
· 2 mentions in chapter, agenda
Matched: “SB576 B. Davis TO AMEND THE COVERAGE OF CONTINUOUS GLUCOSE MONITO…”
|
TO AMEND THE COVERAGE OF CONTINUOUS GLUCOSE MONITORS WITHIN THE ARKANSAS MEDICAID PROGRAM. | B. Davis | Notification that SB576 is now Act 623 |
|
SB585
· 2 mentions in chapter, agenda
Matched: “SB585 G. Leding TO REQUIRE CERTAIN RECORDS BE PROVIDED TO AN EMPL…”
|
TO REQUIRE CERTAIN RECORDS BE PROVIDED TO AN EMPLOYEE WHO IS A MINOR. | G. Leding | Died on House Calendar at Sine Die adjournment. |
|
SB587
· 2 mentions in agenda, chapter
Matched: “…k J. Love SPECIAL ORDER OF BUSINESS Number Sponsor Subtitle SB587 G. Leding TO CREATE THE PARENTS' PEACE OF MIND ACT; TO ESTA…”
|
TO CREATE THE PARENTS' PEACE OF MIND ACT; TO ESTABLISH AUTHORIZATION FOR AND USE OF … | G. Leding | Died in Senate Committee at Sine Die adjournment. |
|
SB589
· 2 mentions in chapter, agenda
Matched: “SB589 C. Penzo TO CREATE THE 340B PROGRAM TRANSPARENCY ACT; AND T…”
|
TO CREATE THE 340B PROGRAM TRANSPARENCY ACT; AND TO AMEND THE LAW CONCERNING TRANSPARENCY AND … | C. Penzo | Died in Senate Committee at Sine Die adjournment. |
|
SB591
Act 973
· 2 mentions in chapter, agenda
Matched: “SB591 C. Penzo TO PROHIBIT RACE-SELECTION ABORTION IN THIS STATE;…”
|
TO PROHIBIT RACE-SELECTION ABORTION IN THIS STATE; AND TO CREATE THE RACE DISCRIMINATION BY ABORTION … | C. Penzo | Notification that SB591 is now Act 973 |
|
SB601
Act 971
· 2 mentions in chapter, agenda
Matched: “SB601 Hester TO CREATE A PATHWAY FOR A GRADUATE OF A FOREIGN MEDI…”
|
TO CREATE A PATHWAY FOR A GRADUATE OF A FOREIGN MEDICAL SCHOOL TO BE LICENSED … | Hester | Notification that SB601 is now Act 971 |
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SB603
· 2 mentions in chapter, agenda
Matched: “SB603 C. Tucker TO REQUIRE AN AIR AMBULANCE TO CONTACT THE ARKANS…”
|
TO CREATE EMMA'S LAW; AND TO REQUIRE AN AIR AMBULANCE TO CONTACT THE ARKANSAS TRAUMA … | C. Tucker | Died in House at Sine Die adjournment. |
|
SB606
· 2 mentions in chapter, agenda
Matched: “SB606 B. Davis TO AMEND THE USED TIRE RECYCLING AND ACCOUNTABILIT…”
|
TO AMEND THE USED TIRE RECYCLING AND ACCOUNTABILITY ACT; TO CREATE THE TIRE MANAGEMENT AND … | B. Davis | Died in Senate Committee at Sine Die adjournment. |
|
SB95
· 2 mentions in chapter, agenda
Matched: “SB95 C. Penzo TO AMEND THE ARKANSAS ATHLETIC TRAINERS ACT; AND T…”
|
TO AMEND THE ARKANSAS ATHLETIC TRAINERS ACT; AND TO CLARIFY THE DEFINITION OF "ATHLETE" WITHIN … | C. Penzo | Died in Senate Committee at Sine Die adjournment. |
|
HB1225
Act 30
· 1 mention in transcript
Matched: “motion to accept the amendment on House Bill 1225.”
|
AN ACT FOR THE BLACK RIVER TECHNICAL COLLEGE APPROPRIATION FOR THE 2025-2026 FISCAL YEAR. | Joint Budget Committee | Notification that HB1225 is now Act 30 |
|
HB1456
Act 852
· 1 mention in chapter
Matched: “HB1456 Rose TO AMEND THE STATE KIDNEY DISEASE COMMISSION TO BE AN…”
|
TO AMEND THE STATE KIDNEY DISEASE COMMISSION TO BE AN ADVISORY COUNCIL TO THE DEPARTMENT … | Rose | Notification that HB1456 is now Act 852 |
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HB1523
Act 951
· 1 mention in chapter
Matched: “HB1523 Vaught CONCERNING MISSING PERSONS ALERTS; TO CODIFY THE ARK…”
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CONCERNING MISSING PERSONS ALERTS; TO CODIFY THE ARKANSAS AMBER ALERT SYSTEM; TO CODIFY THE ARKANSAS … | Vaught | Notification that HB1523 is now Act 951 |
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HB1619
Act 634
· 1 mention in chapter
Matched: “HB1619 Gramlich TO SET ADMINISTRATION FEES UNDER THE ARKANSAS MEDI…”
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TO SET ADMINISTRATION FEES UNDER THE ARKANSAS MEDICAID PROGRAM FOR IMMUNIZATIONS AND MONOCLONAL ANTIBODIES FOR … | Gramlich | Notification that HB1619 is now Act 634 |
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HB1682
Act 942
· 1 mention in chapter
Matched: “HB1682 Puryear TO CREATE THE GOOD NEIGHBOR ACT; AND TO CLARIFY FOO…”
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TO CREATE THE GOOD NEIGHBOR ACT; AND TO CLARIFY FOOD DONATION LIABILITY AND IMMUNITY. | Puryear | Notification that HB1682 is now Act 942 |
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SB110
· 1 mention in chapter
Matched: “SB110 C. Penzo TO AUTHORIZE CERTIFIED NURSE AIDES OR CERTIFIED NU…”
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TO AUTHORIZE CERTIFIED NURSE AIDES OR CERTIFIED NURSING ASSISTANTS WHO PROVIDE IN-HOME SERVICES TO BENEFICIARIES … | C. Penzo | Died in Senate Committee at Sine Die adjournment. |
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SB12
· 1 mention in transcript
Matched: “Make a motion to accept the amendment. And on House of Senate Bill 12”
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TO AMEND THE FREEDOM OF INFORMATION ACT OF 1967; AND TO AMEND ARKANSAS LAW CONCERNING … | B. King | Died in House Committee at Sine Die adjournment. |
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SB221
· 1 mention in agenda
Matched: “…RTAIN ENERGY ISSUES. DEFERRED BILLS Number Sponsor Subtitle SB221 B. Davis TO PROHIBIT RISK-BASED PROVIDER ORGANIZATIONS FROM…”
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TO PROHIBIT RISK-BASED PROVIDER ORGANIZATIONS FROM USING CERTAIN TYPES OF CONTRACTING PRACTICES WHEN CONTRACTING WITH … | B. Davis | Died in Senate Committee at Sine Die adjournment. |
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SB273
· 1 mention in agenda
Matched: “…OVIDER-LED ORGANIZED CARE ACT; AND TO DECLARE AN EMERGENCY. SB273 D. Wallace TO REQUIRE DIALYSIS CENTERS TO HAVE A BACKUP GEN…”
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TO REQUIRE DIALYSIS CENTERS TO HAVE A BACKUP GENERATOR ON SITE. | D. Wallace | Died in Senate Committee at Sine Die adjournment. |
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SB306
· 1 mention in chapter
Matched: “SB306 C. Penzo TO REQUIRE THE DEPARTMENT OF HUMAN SERVICES TO APP…”
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TO REQUIRE THE DEPARTMENT OF HUMAN SERVICES TO APPLY FOR A HOME- AND COMMUNITY-BASED SERVICES … | C. Penzo | Died in Senate Committee at Sine Die adjournment. |
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SB474
· 1 mention in chapter
Matched: “SB474 C. Penzo TO AMEND THE LAW CONCERNING PUBLIC WATER SYSTEMS;…”
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TO AMEND THE LAW CONCERNING PUBLIC WATER SYSTEMS; AND TO ALLOW THE BOARD OF A … | C. Penzo | Died in Senate Committee at Sine Die adjournment. |
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SB542
· 1 mention in agenda
Matched: “…EQUIRE DIALYSIS CENTERS TO HAVE A BACKUP GENERATOR ON SITE. SB542 B. Davis TO AMEND THE MEDICAID PROVIDER-LED ORGANIZED CARE…”
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TO AMEND THE MEDICAID PROVIDER-LED ORGANIZED CARE ACT; TO IMPROVE THE ENROLLMENT AND SELECTION PROCESS … | B. Davis | Died in Senate Committee at Sine Die adjournment. |
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SB543
· 1 mention in agenda
Matched: “…GANIZATIONS; AND TO EMPOWER BENEFICIARIES WITH INFORMATION. SB543 B. Davis TO REQUIRE CERTAIN REIMBURSEMENT RATES FOR HOME- A…”
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TO REQUIRE CERTAIN REIMBURSEMENT RATES FOR HOME- AND COMMUNITY-BASED SERVICES WITHIN RISK-BASED PROVIDER ORGANIZATIONS. | B. Davis | Died in Senate Committee at Sine Die adjournment. |
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SB598
Act 743
· 1 mention in agenda
Matched: “…Y- BASED SERVICES WITHIN RISK-BASED PROVIDER ORGANIZATIONS. SB598 J. English TO AMEND VARIOUS LAWS RELATED TO THE DIVISION OF…”
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TO AMEND VARIOUS LAWS RELATED TO THE DIVISION OF WORKFORCE SERVICES; AND TO AMEND THE … | J. English | Notification that SB598 is now Act 743 |
Machine transcript
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- Source
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- ggml-large-v3-turbo.bin
- Processing date
- October 7, 2026
Senator Dave Wallace
Unverified
0:00
we're going to get started. I've got a quick amendment that Mr. Kalen Hyland I think wants to present. Senator Breanne. Davis you are welcome to go right ahead. And Senator Davis Tell us which bill this is for.
Senator Breanne Davis
Unverified
0:31
This is House Bill 1255, and I have an amendment. Breanne Davis, State Senate, District 25. Senator Davis,
Senator Dave Wallace
Unverified
0:40
we need you to sign it real quick.
Senator Breanne Davis
Unverified
1:17
Yep. 1255. You guys have already heard it and it passed out of committee. I've got an amendment
Senator Dave Wallace
Unverified
1:22
to it. And you are recognized?
Senator Breanne Davis
Unverified
1:28
Thank you, Mr. Chair. The amendment is pretty simple. It just takes out three words on page two,
line six. Will you read? Well, hang on one second. Thank you.
It just strikes processes and paperwork. The reason for this is DMEs have a different prior authorization process than pharmacies. And so we want to make sure that people are getting their supplies quickly, efficiently. And so we want them to be consistent, but the process and the paperwork is a little bit different between the two. So we're striking that language just to ensure that we don't hold anybody up.
Senator Dave Wallace
Unverified
2:27
happy to take any questions members are there any questions seeing none is there anybody from the audience that would like to say for or against seeing none what is the will of the committee i have a first and a second all in favor say aye aye any opposed congratulations your amendment is passed thank you yes ma'am sister hammer yes sir sir you say you have a couple of yes sir
Speaker 27
2:57
Mr. Chair, Mr. Chair, let me have a point of order because we needed to adopt the amendment. We didn't we did we adopt the amendment before we voted on the bill. So, so, yeah, but let's go. Let's go back and adopt the amendment. So just to make sure that process goes through correctly.
Senator Dave Wallace
Unverified
3:31
It's the same in the member. Members, we
Senator Dave Wallace
Unverified
3:44
start over. Second. Okay, all in favor say aye. Aye. Any opposed? Seeing
Speaker 27
3:51
none. Now let's start over. Okay, I will make a
Senator Fredrick J. Love
Unverified
3:57
motion to accept the amendment on House Bill 1225.
Senator John Payton
Unverified
4:02
Second. I have a first and a second. All in favor, say aye. Aye. Any opposed, say nay. Nay. Seeing none,
Speaker 40
4:16
congratulations again. Do I make a motion? I have
Senator John Payton
Unverified
4:20
a motion and a second. All in favor, say aye. Aye. Any opposed? Seeing none. You bet. Aye, aye. And Senator Hammer?
Senator Kim Hammer
Unverified
4:35
Thank you, Mr. Chair. I'd like to present Senate Bill 546 first, please. Sir, you're recognized? Thank you. This is an agreed-upon bill with ADQ, worked with them for probably a couple months, and some of the folks that are in the industry dealing with domestic sewage treatment works. And I'll go through the bill and give you the high points. The first thing is that it addresses systems that would be placed within a five-mile radius
to determine that there is a viable option for future hookups, And it allows ADQ to be involved in that process to make sure that if there's a viable option, that that is being taken into consideration. The second thing it does is if you look over at page four, it reduces the percentage from 10% down to 8% and not to exceed $100,000. And the reasoning behind this is there is a cap on this fund of $2.1 million.
and what is ending up happening is you have a few that are actually contributing the vast majority toward that goal. It does not take the cap off the goal. It stays at the same at 2.1, but what it does is it begins to levelize now that that fund is being used since it was originally set up, because what was going to end up happening, a few investors were going to make up the vast majority of the money in it, so those coming behind them would not have to contribute to So what this does is just adjust it to what the reality is since the bill went into place.
The other thing that I want you to note is as far as that fund being tapped, I think it was $20,000 is all. So the fund is growing expeditiously because they're able to invest the money back, which is going into contributing to the growth of that fund as well. But there's very little that is being taken out of the fund. And this was originally established by one of our fellow House members back when I was in the House. And when it was started, they knew that there would be some adjustments that would need to occur
after it actually started getting used and started happening. So this is the adjustment. As I said, ADQ is supportive of this bill, worked with them diligently over the last two months in order to get it to this product that they're agreeable to. And I'll be
Senator John Payton
Unverified
7:05
glad to answer any questions. Senator Payton, you're working on that, sir. Thank you, Mr. Chair. I'm just curious about the five-mile moratorium
Senator Kim Hammer
Unverified
7:14
radius. What's the reasoning on that? It's because there are some sewage treatment plants that are being put in without taking into consideration
what's the cost going to be whenever growth expands out and being able to transfer from that sewage treatment plant into a municipality. And all this does is allow for a review to be taking place. It doesn't stop. It doesn't require permitting. It's just putting a little bit of oversight to make sure that that is being taken into consideration. Well, I would
Senator John Payton
Unverified
7:46
think the division, or DEQ, whatever we call it these days, I would think they have that
authority already to take that into consideration.
This says that they won't consider it within five miles. No, I read this this
Speaker 54
8:02
morning, and that's how it reads. It was kind of confusing to me. Let me read it real quick. I
Senator John Payton
Unverified
8:10
mean, there's a couple of exemptions that says they can consider it within the five miles if it meets these criteria, but it starts off by putting a
Speaker 58
8:19
moratorium within five miles. They shall
Senator Kim Hammer
Unverified
8:22
not consider application, and if you drop down to line 29 where it says unless the division determines those,
those are the two criterias for them to determine. I
Senator John Payton
Unverified
8:33
would think they already have the authority to say yes or no, whether it's within five miles or outside of five miles, but I was
Senator Kim Hammer
Unverified
8:39
just curious what the reasoning was. It's just a little bit of a, it's kind of getting it above the radar screen a little bit more so that it's looked at a little bit harder. Okay, thank you. You're welcome. And again, they were, you know, they were factored into the decision. I don't know if they're in the room. I know they were down at state agency, but I don't know if they made it up into the room
or not. And I think if you look at B there, Senator Payton, if you mind speaking. I think
Speaker 69
9:28
the director's coming up here. Hi, good morning. Bailey Taylor, DEQ Director and Chief Administrator of Environment.
Senator John Payton
Unverified
9:31
Senator Payton, you want to ask if the chair allows? I don't know if I'm still recognized, but we'll go until they stop us. Yeah, I was just looking for the explanation on why we needed to put the moratorium in place,
Speaker 69
9:53
even with the two caveats that it can be overridden. Go ahead. We don't currently have the authority to dictate where a plant
Speaker 71
9:58
is located. We would just make sure that once the plant is located, that it is protective of human health and the environment with its discharge.
So, like the senator said, you know, if you have multiple private municipal or non-municipal wastewater treatment plants located near each other, it's an opportunity to look at regionalization. Okay, so you're saying currently they can
Senator John Payton
Unverified
10:21
put one in without DEQ's approval, without permitting? No, no, sir. We don't have the
Speaker 71
10:30
authority to dictate whether or not they can put one in close to another existing facility.
Senator John Payton
Unverified
10:38
So you have to approve it if it meets other criteria? Correct. Okay, thank you.
Senator Missy Irvin
Unverified
10:44
Thank you. Are there other questions from members of the committee? Seeing
none, is there anyone here to speak for or against this bill? There is not. You're recognized to close for your bill, Senator
Senator Kim Hammer
Unverified
10:56
Hammer. Thank you, Madam Chair. I think we've explained it thoroughly and would appreciate a good vote. Okay, what
Senator Missy Irvin
Unverified
11:02
is the pleasure of the committee? Motion to pass a second. All those in favor say aye. Aye. And opposed?
Speaker 79
11:09
As have it, congratulations. You've passed your bill.
Senator Kim Hammer
Unverified
11:11
Thank you, Madam Chair. Thank you. Possibility to run 444 while I'm sitting at the table. I've got a short presentation. Go ahead. Senate Bill 444, Kim Hammer State Center, District 16. I'm going to read through what the bill does and I'll identify the lines by which it does it. If you want to take a look at page one, line 22, add medical research to the list of healthcare services covered by the Medical Ethics and Diversity Act of 2021, that it
was Senate Bill 289. Most medical research is not completed as part of the specific patient's healthcare, therefore most medical research, which can be controversial at times, isn't currently protected. Instances of such include research on aborted fetuses or gain-of-function viruses. If you look at page 22, lines 25 through 27, this new language includes broad conscience protection regarding those three highly controversial procedures. While other health care conscience protections already exist in Arkansas, they are limited for some
workers. This section ensures no health care worker has to participate in those procedures in any time. If you look at page 4, lines 19 through page 5, line 15, this is actually one of the most important sections of the entire bill, and this is on Senate Bill 444. This provides job safety protections for healthcare providers who are whistleblowers. In turn, this enhances patient safety, and we want you to think about those who are part of a gender transition procedure,
therapies or other related services who want not to participate due to their belief that this would hurt children's body but didn't have the ability not to participate. This is an effort to get ahead of an issue, allowing health care workers to bring up their concerns. Even if an employer does not recognize such objection, a health care worker is allowed to go to the government authorities to seek protection for any discrimination. And then page 5, line 17 to the end of the bill, Part A, state boards and state agencies are not allowed to punish or retaliate against a healthcare provider for providers' expression
of protecting free speech unless such speech resulted in harm to the patient. And then Part B prohibits state boards or agencies to force a person to be a member of a particular private licensing agency. And that is the highlight of what the bill does, Madam Chair. I do have somebody that can come up and help answer questions if there are questions. Okay. Are there
Senator Missy Irvin
Unverified
13:39
any questions from the members of the committee? Any questions? All
right. Seeing none, you can close for your bill.
Senator Kim Hammer
Unverified
13:53
All right. Thank you, Madam Chair. I think it's self-explanatory. Members, I'll be glad to get you a copy of this sheet that I referred to. And with that, Madam Chair, I would just appreciate a good vote from the committee. Thank you. What
Senator Missy Irvin
Unverified
14:03
is the pleasure of the committee? Motion to pass. Second. Any discussion? All those in favor say aye. Aye. And opposed? Ayes
have it. Congratulations. You've passed your bill. Thank you, Madam Chair, members of the committee. Thank you. Senator Penzo. Wait.
There's a, okay, we have a handout. That's correct. I believe there's a handout for your bill. Is that correct? 347. And then Senators 311 will also be special order. I failed to accidentally
left that off as special order. That's my fault. But let's do 347, then we'll go to 587, then we'll go to 311.
And here are some handouts, I believe. If the chair will allow, I've got
Senator Clint Penzo
Unverified
15:10
a few folks to bring up the table with me. Yes, please. Everybody state your
Senator Missy Irvin
Unverified
15:14
name for the record, then please proceed. We'll try to expedite things this
way. Okay, and their fiscal impact is in the folder. Is that correct? That is correct. Okay, so that's the green sheet. Okay, so members, this also in your packet is part of this bill.
If you look, this green piece of paper. Okay, if you'll state your names
Senator Clint Penzo
Unverified
15:39
for the record, you may proceed. Clint Penzo,
Speaker 99
15:46
Senate District 31, Springdale. Billy Tarpley, Arkansas
Speaker 101
15:51
State Dental Association. Jason Havard, Conway, Arkansas, Pediatric
Speaker 103
15:56
Dentist. Aaron Baldwin, Hudsprings, Arkansas, Oral and Maxillofacial Surgeon.
Senator Clint Penzo
Unverified
16:03
Thank you, committee. I'll go ahead
and let the experts talk. This was brought to me by a constituent initially that's a pediatric dentist, and I was shocked at the rates that Medicaid reimburses for pediatric dentistry. It's one of those situations that I dug into a lot, dealing with the fluoride too, oral health outcomes in the state. And I think Medicaid reimbursements could be tied to those poor oral health outcomes.
And I'll let Mr. Tarpley go. Go ahead.
Speaker 99
16:54
Okay. Thank you, Madam Chair, and thank you, Senator Penzo. I bring you greetings from Dr. Terry Fidler, who has laid the groundwork to get us to the point where we are right now. Unfortunately, this conflicted with a trip that he had already made, otherwise he would be here. Today, you'll hear from three dental providers who will testify to the critical nature of this bill.
Now, I'm not a dentist, but if you'll allow a few brief observations, we can move on to the smart people. You're as tired of hearing this as I am of saying it, but it's been 18 years since dentists have had a fee adjustment to the Medicaid fee schedule. meantime, supply costs have increased, inflation has grown, and dentists have continued to serve the Medicaid population increasingly out of their own pockets. In deference to the overall cost of this ask, the bill uses a graduated scale to implement the increase over three fiscal years
using published fees from the National Dental Advisory Comprehensive Fee Report. The consent decree that was handed down from U.S. District Court in 1994 established a legally binding agreement that DHS keep payment rates at a level necessary to maintain a sufficient number of providers. Since 2014, 11 years ago, DHS has utilized rate reviews that have ultimately denied any increase to the fee schedule. The advent of managed care eight years ago didn't
help our cause to increase fees. And now, of course, we're back in the world of fee for service with yet another request for a fee adjustment. To the core of the dental association's concern is the survey of Medicaid dentists that was conducted in 2022, in which the following statistics stood out. 84% of the dentists that responded, there were 209 dentists who responded, so a good cross-section, 84% of those indicated that they may have to stop treating Medicaid
patients if rates remain unchanged. Of that same number, 80% said they will have to stop or reduce treatment within three years if rates remained at current levels. We're now in the third year of that survey, and of the number of dentists that said the fees were adequate, that was only 3% of those who responded. The handout that you have before you includes a table showing 10 of the most utilized procedure codes in Medicaid dental. It further demonstrates how inadequate
the current reimbursement rates are compared to the published fee report that's based on market rates. So thank you again for the opportunity to present today. And Madam Chair, with your permission, I would ask that the committee hear from Dr. Aaron Baldwin, Dr. Jason Havard, and Dr. Mark Bailey, who have all prepared remarks within a brief time limit, because we're aware of time constraints. Absolutely. Before we go to
Senator Missy Irvin
Unverified
19:56
that, I think I'm going to ask for questions real quick. Is that okay? Senator Love, you
Senator Fredrick J. Love
Unverified
20:04
have a question. Thank you. So I'm looking at your chart right
here. Now, the numbers that you have in year one, year two, year three, and I'm seeing the overall 100% impact, are those at current market rate right now?
Speaker 113
20:21
Actually, Senator, those numbers come from DHS. We
Speaker 99
20:25
saw this report yesterday. The numbers, which is what we're asking for, are going to be quite a bit more than that. That's unlimited procedure codes. We're asking for fees on all the
entire span of Medicaid procedure codes to be increased. In addition to that, increasing the cap on dental treatment
Speaker 114
20:47
for special needs adults. Okay, so I guess, so
Senator Fredrick J. Love
Unverified
20:51
these, you're asking for, are you looking at this chart? Have you seen this
chart? I don't have that. I have it somewhere, but okay. So I'm asking, so you said this was provided by Medicaid, by DHS. Yes, sir. So say,
for instance, the periodic oral exam established patient, right? So you're saying right now that's $26.20 for the reimbursement, right? Correct. So there's one year, one year, two year, three. Are you saying that your numbers
Speaker 114
21:23
are going to be higher than these numbers? These numbers, the numbers for these codes that
Speaker 99
21:30
are listed here are more than likely correct, although they used the 2024 reports rather than the published 2025. But other than that, these numbers are correct,
Speaker 102
21:42
but they're only correct for the limited number of procedure codes you see on this chart.
Senator Fredrick J. Love
Unverified
21:47
Okay. But I guess my question is, are you asking for more than this? No, sir. As far as the procedure, that's all I'm asking
Speaker 113
21:56
for. No, sir. That number, I'm sure, is correct on each procedure code that you see listed. What we're saying is there are far more procedure codes. No, I got that, but I'm just saying, okay,
Speaker 118
22:04
all right. Thank you. Thank you, Madam Chair. Thank you.
Senator Missy Irvin
Unverified
22:12
Okay, I'm going to do something, and I apologize, but Senator English is here. I'm going to just take a pause in this. She's a chairman of education. I've got to get her back. So I apologize, but just stay where you are. Just let Senator English come, and we're going to run her bill real quick. And just stay where you are. Just let Senator Penzo, and we'll let Senator English real quick run her bill, because I've got to get her back to chairing education.
Mr. Tarpley, just stay where you
are. Thank you. Okay. So,
Senator English, this is Senate Bill 560, members. Senate Bill 560, we did hear this bill last night. Senator English, state your name for the record,
Senator Jane English
Unverified
23:03
and then please proceed on Senate Bill 560. Thank you, Senator Jane English, District 13, and I'm here to present the Senate Bill 560, which basically takes the unemployment insurance trust fund as a very large balloon in really
good shape, and it has a trust fund equal, a little program, workforce training program, and it has been receiving $2.5 million. So what we're proposing to do is just to move some of the trust fund, unemployment insurance trust fund, into that industry training program trust fund, up to $6 million a year. There'll be absolutely no effect on employers. It's just moving changing the percentage of money that goes in for the for the base okay are there questions
Senator Missy Irvin
Unverified
23:59
from members of the committee on this bill any questions no questions close for your
bill close what's the pleasure of the committee motion to pass second all those
in favor say aye and opposed eyes have it thank you senator penzo thank you Okay. Senator Love, you had any other questions? Okay. So, I
have a question for Mr. Tarpley real
quick. So, we're back, folks, to 347. These codes, actually, they're utilized not just by
Speaker 99
24:35
dentists. Is that correct? Senator, I don't know the answer to that question, but probably some of the topical fluoridation applications could be used by physicians. That's correct. Because you all changed the law
Senator Missy Irvin
Unverified
24:51
to allow that. Yes, ma'am. So actually this, yeah, it does affect primary care and pediatricians, correct? That's correct. Okay.
I just wanted to make sure I was clear about that.
Right. Okay. Now we'll hear testimony. Thank you for being patient and waiting.
Speaker 103
25:10
Thank you, Aaron Baldwin, again, Hot Springs. Just a quick background on myself. I'm a board-certified oral and maxillofacial surgeon at Hot Springs after completion of undergraduate school, dental school, medical school, and oral and maxillofacial surgery residency. I made the decision to move back home to my hometown of Hot Springs in 2014, where I've been a Medicaid provider for dental and medical since then. The scope of my practice includes dental extractions, implants, corrective jaw surgery,
Facial Trauma and Reconstruction, Management of Severe Head and Neck Infections. I also serve as the President for the Arkansas State Society of Oral and Maxillofacial Surgeons. And I am Arkansas's delegate for the American Association of Oral and Maxillofacial Surgeons governing body. As with all Medicaid providers, we constantly encounter barriers to provide the much-needed services for our patients.
These barriers include time-consuming submissions for prior authorizations, dealing with downcoding, denials, and for the authorizations of these procedures. This requires well-trained and well-paid staff to submit and go through the appeals process. This obviously increases our costs and ability to provide care in a timely manner. Exponentially compounding this problem is the lack of increase in fee schedules since 2007,
despite substantial inflation, most notably over the last few years. These problems in the Medicaid system make the business model of providing care for Medicaid patients financially unreasonable and unsustainable. For example, Medicaid reimbursement for my most commonly utilized non-hospital-based procedures ranges from 32% to 44% of my fees. An average overhead for a dental office is approximately 65% for an oral and maxillofacial
surgery practice, slightly less than that. If a procedure reimbursement is only 40% of my fees, my overhead is approximately 20% more than I'm being reimbursed. So essentially, I am subsidizing at least 20% of the funds needed to the break-even point. For this reason, my practice was forced to stop seeing the new Medicaid dental patients as of January 1, 2025, unless there's a true emergency present.
Consequently, our revenues have gone up close to 12% year-to-date versus 2024. And unfortunately, my practice is one of many that are making the decision to stop seeing patients. My hope is that the Senate Bill 347 passes so that my practice, as well as other dental practices, can continue to provide Medicaid patients with the much-needed dental care.
Should Senate Bill 347 not pass, it is very likely that the majority of oral and maxillofacial surgeons, along with substantial numbers of pediatric, orthodontic, and general dentists throughout the state will no longer be Medicaid providers, leaving a large population of Arkansons with no access to dental care, especially our most deserving population, including children and special needs adults. Thank you. Thank you.
Senator Missy Irvin
Unverified
29:08
Are there any questions? Thank you. Please proceed.
Speaker 101
29:14
Again, my name is Jason Havard. I'm a resident of Conway. I'm a pediatric dentist who's had the privilege of serving Arkansas's pediatric Medicaid population for just over 20 years. I'm also a small business owner with offices in Conway and North Little Rock. I work alongside five other exceptional pediatric dentists and about 42 employees who work hard to care for our patients. I serve as the president of the Arkansas Society of Pediatric Dentists. This group represents approximately 60 pediatric dentists across our state, all of whom are Medicaid providers and almost all of whom
take new patients. I graduated from Harding University. From there, I went to complete dental school at Baylor College of Dentistry. That's what it was called now, unfortunately now, Texas A&M College of Dentistry. Following dental school, I completed a 24-month residency in pediatric dentistry based out of the dental school, Dallas Children's Hospital, Texas Scottish Rye Hospital and numerous public health clinics. We'll take just a second to talk about who we are as pediatric dentists and how we function
in the Medicaid system here. We provide primary and specialty oral care for the children of Arkansas, including those with special health needs. Primary meaning we are many of these children's first dentists, start seeing them at one year of age. meaning we see them through graduation. They come to us twice a year for their checkups and re-care appointments. If they need additional treatment, we may see them multiple times during the year. We develop connections with these families,
and we literally watch them grow up before our eyes. A good friend and colleague of mine recently said, one of the gifts of my profession is just that. We watch the kids grow up. If we stay around long enough to do this, We get to see their kids entrusted to our care as well, so that's a special gift of our profession. As specialists, we receive referrals from general dentists and pediatricians. They refer to us for multiple reasons, mainly for young kids who need extensive dental work,
also for those who have special health care needs. We may only see those kiddos for two or three visits and then return them to their dental home. It's easy to say we share a sense of passion, a sense of responsibility for taking care of these young patients. If any of you received a letter from me, which I sent out a lot of in support of this, one of the statements that I make is that by virtue of our training, we are uniquely qualified to take care of this vulnerable population.
What that means is we have extensive training and additional training in child psychology. We have additional training in hospital dentistry. We have additional training in treating those with special health care needs. Our training prepares us to take care of these kids, but we do not take care of these kids alone. We rely on a partnership with guys like Dr. Baldwin, guys like Dr. Bailey here to serve these patients. Our participation and collaboration is important and it's crucial to the program.
I also want to take just a moment to discuss the Medicaid population. Approximately 50% of our state's children rely on Medicaid for their dental care. These children experience significant disparities in oral health based on their socioeconomic status. To put it simply, our poorest children often have the worst dental health. Our children on Medicaid have higher rates of dental disease, including early childhood caries, which is a particularly potent form of dental cavities.
Early childhood caries is the replacement for what many of you have heard of, nursing bottle caries or baby bottle caries. So early childhood caries is the most common chronic disease of childhood. It's even five times more common than asthma. If it's left untreated, it leads to costly problems including hospitalizations and emergency room visits. Our own Academy of Pediatric Dentistry highlights the effects on children, increased dental treatment costs, loss of school days, diminished ability to learn, and a
general lower quality of life. I'm here before you today as a passionate advocate for Arkansas's children, particularly those who rely on Medicaid for their dental care. As a pediatric and small business owner, just like Dr. Baldwin, I'm deeply concerned over our dental Medicaid reimbursement rates. Simply put, the rates are not sustainable. Let me provide a little bit of context. The last time, as we said before, has been 18 years ago. During the same time frame, the The cumulative rate of inflation stands just north of 50%.
The cost of attracting and retaining employees is exploded. Lease rates have increased by 40%. Price of supplies have doubled in many cases. A lot of businesses can just raise their fees. Mine are set contractually by what the fees are posted on Arkansas's Medicaid fee schedule there. If I raise my fees, it does nothing for my office. I receive no additional revenue from Medicaid. Simply put, if McDonald's pays more for its beef, they're passing along that cost to you and your hamburger.
That's not possible for businesses like ours. 18 years without a rate adjustment leaves me struggling with an obligation to continue to care for these kids while maintaining a financially viable business. One thing's for certain, I can't continue to serve in the same capacity today based on 2007 rates. It's just no longer feasible. These feelings aren't unique to me. As Billy has said before, he sent out a survey. I sent out a survey among pediatric dentists with basically the same information coming back.
Most will move to limit or stop Medicaid participation. Some who rely along border states, share borders with Louisiana and Missouri. Some will discontinue or limit seeing Arkansas' own children and opt to see patients from Louisiana and Missouri because the rates are more reasonable. In my years of practice, I've witnessed firsthand the profound impact that Medicaid has on the lives of children across our state. It's a crucial safety net. I want to continue to be a part of
this program. My colleagues want to continue to be a part of this program, and we need your help. We need your help to pass SB 347. It'll put reimbursement rates more in line with the cost associating with providing high-quality pediatric care. Summing it up, why does all this matter? The most obvious answer is that this affects untreated dental issues, affect children. And it's not just as simple as a kid with a toothache. The effects are far-reaching. Poor dental health can lead to problems with self-esteem, academic performance, speech, eating, sleeping, you name it.
It's a major factor contributing to children missing school, which impacts their ability to learn and succeed. Children with untreated dental issues end up in emergency rooms. Emergency rooms cannot provide the care that we do in dental offices, and they certainly cannot provide cost-effective care. An example of a kid showing up in an emergency room, a five-year-old with a swollen face, can't sleep at night, winds up in the emergency room in the middle of the night.
The ER physician is going to look at that kid, say you've got a bad tooth, put him on an antibiotic, may prescribe a narcotic, and say you've got to go see your dentist. All that could be prevented if the kid has a dentist. We can treat the cavity, we can prevent the cavity, we can be the service that they call over the weekend rather than go into the emergency room. This sort of thing saves the state money. By increasing fees, we can prevent many of these emergencies, saving Arkansas taxpayers money.
Because all this matters, I urge you to support SB 347 by increasing the reimbursement rates. We can continue to provide this care for our patients. Now is the time to act. Arkansas children need us. They don't need to wait any longer for this. The status quo is simply not sustainable. Prioritize this issue and work with us to secure
Speaker 54
37:36
this increase. Okay. I'm sorry, but I'm not
Senator Missy Irvin
Unverified
37:40
going to take that motion yet.
I just need to have a disclosure.
So I'm going to announce disclosure for myself, just because my husband would be affected because he does do the topical application of fluoride. So this bill would directly affect him. So there's my disclosure. You have a question? Yes. you're recognized. Thank you, Madam Chair. I'm sorry I had
Senator John Payton
Unverified
38:11
to be out of the room if y'all covered this while I was out, but I mean, I hear all
the reasonings for having dental work and for these
people being treated and such. The question is the rate, and so I'm reading the bill and it talks about 60 percent of 50 percentile. Can anybody explain the reasoning and how this rate is being
Senator Clint Penzo
Unverified
38:41
set. So the 50th percentile is just the average of the country. And when everybody's getting excited about only getting 60% of the 50th percentile, that
tells you how much of a problem
we have. I don't know if anybody can answer the 50th percentile. If DHS
Senator Missy Irvin
Unverified
39:00
can come to the table, please. DHS, can you please come to the table and answer Senator Payton's
Senator John Payton
Unverified
39:08
questions? So do we know where Arkansas ranks in that
Senator Clint Penzo
Unverified
39:12
percentile currently? I believe we're pretty close to the bottom, but maybe they can answer
Speaker 142
39:20
it. Okay. Janet Mann, DHS, could you repeat the question, please? Well, I'm not sure
Speaker 61
39:25
you're the proper one to answer my question.
Senator John Payton
Unverified
39:27
I was asking the bill's sponsor and his contingency here what their reasoning was for how they came up with a formula to set the rate. I'm not qualified to answer. I
Senator Missy Irvin
Unverified
39:42
don't know how they said it. I'm
Senator Clint Penzo
Unverified
39:46
just trying to find out. So I'll go ahead and answer. If one of them wants
to tell how low we are on the scale, that'd be great. but I know we're near the bottom of reimbursement rates in the country.
So they took the average rate and then asked for 60% of that to bring us up higher
Senator John Payton
Unverified
40:10
in the reimbursement rates. Okay, so this Dental Advisory Service Comprehensive Fee Report, who creates that? Is that coming straight from DHS reimbursement? From Medicaid reimbursement, or is that a retail fee report?
Speaker 99
40:32
Senator, I'm glad you asked that question. That comes from a published report that's done by a third party that received the fees that are in here. The rates are taken from insurance claims and also
Senator John Payton
Unverified
40:50
surveys of dentists around the country. So the insurance claims is good. Yes, sir. Here's my problem. recently, a couple years ago, dealt with the insulin situation and manufacturers that had artificially inflated retail price and then a bunch of kickbacks and stuff. I wanted to make
sure that this report that we're using is not some artificial retail price report. No, sir. It's a highly dependable report
Speaker 99
41:18
and what many dentists use. And going back to the 50th percentile. If you look at the full range, we all understand 50th percentile. But if you look at the handout that was there based on those procedure codes, even at the 50th percentile, that's adjusted for Arkansas. So it makes it even lower than the 50th percentile for the rest of
Senator John Payton
Unverified
41:43
the nation. So that number is adjusted. And so just to be clear,
it's not setting it as we would compare to other states on Medicaid
Senator Missy Irvin
Unverified
41:55
reimbursement? No, sir. Okay. No, sir. Thank you. Thank you, Madam Chair. I do have a question for DHS, though. Where are we? I think
that was one of Senator Payton's questions. Where are we in the rank of our reimbursement rates when it comes to dental as it compares to the
Speaker 153
42:09
rest of the states? Thank you for the question. So in January, we began a rate review.
Speaker 155
42:14
Could you speak into the mic? Yes. Sorry. In January, we began a rate review for dental as agreed when we moved it from managed care back to fee-for-service that we would start it in January. We're on the verge of being able to publish that. We usually, in our rate reviews, we do compare it to surrounding states and we do compare it to Medicare, which we have done in the past two previous rate reviews that was referenced earlier in testimony that saw no rate increase. When we originally began this process, we had a selection of, I think, two pages of codes that were highly used.
And it compared it to the surrounding states. I think there were eight approximately. And three to five of those codes, we were in the bottom four. The rest of the codes, we were in the top four categories of payment. And so we took that into our rate review to continue. And we just don't have those published yet for public comment. When will you have that?
Speaker 157
43:15
It was due. It's due this week. It's due this week.
Senator Missy Irvin
Unverified
43:20
Okay. Okay, it's due this week. Senator Love has a question.
Senator Fredrick J. Love
Unverified
43:25
Okay, so what is this based on? Yeah, I'm
Senator Fredrick J. Love
Unverified
43:32
down and explain that. Because I'm going to ask you what this is
Speaker 27
43:37
based on, and then if this was law, how would this match up? So what are
Speaker 161
43:44
these numbers? Yes, sir. So when we look at rates, typically what we do is take the top 80% of codes built.
Speaker 163
43:52
So what that means is 80% of Medicaid spend is accounted for by the codes on that list. And you can see on there, like the top one is billed 300,000 times versus the lowest one is billed 1,000 times. So we're getting to a really small amount of billed codes when you get off that list. So that's why we don't necessarily look at those when we do rate reviews. So that's what that list accounts for. There is 20% of what is billed to Medicaid that is not accounted for on that list that I have just asked our finance team to pull and rerun for us so that we'd see that whole picture. Gotcha. Okay.
Senator Fredrick J. Love
Unverified
44:22
So where did you get these numbers? Those numbers are
Speaker 163
44:26
from the book that he provided. Those are not what we use in our rate review. So that is what is in this bill. Okay, so
Senator Fredrick J. Love
Unverified
44:36
these are the numbers that you're saying that you want. All right, so these numbers match up with this? Yes, sir. Okay. All right, that's what I needed to know. Yeah,
Senator Missy Irvin
Unverified
44:50
I think they did a fiscal impact based on the language in the bill,
Which is why you have the code specific to the rate review study
that is designated in the bill. Okay, so then... Correct. Yes, yes. All right,
Senator Fredrick J. Love
Unverified
45:07
so let me ask you. So year in PAC-3, we see the federal share is a little over six... A total is 8.7 million, just say 8.7. and then we have $8.7 million, the estimate for the special needs population.
Is that, so we're talking about $17.5 million or so
Speaker 161
45:34
for the total impact? Let me read that so I can make sure.
Speaker 144
45:41
eyes on. Yeah, I've got to put my eyes on. Yeah, you have
Senator Missy Irvin
Unverified
45:46
the federal share and the state share. So that is one
Speaker 163
45:49
of the things I'm trying to get clarification on, on whether or not they did include that additional special needs. I know we had difficulty determining that population
because that term is not used as a diagnosis for us. So I need to clarify that, but I believe that is the total impact. All
Senator Fredrick J. Love
Unverified
46:06
right, so that would be, would it be the 17 and a half, like 17 and a half million, or would it be just... No,
Speaker 178
46:13
it'd be the 8.6 per year going forward
Speaker 27
46:16
from year three. And that includes the special needs population? That is
Senator Missy Irvin
Unverified
46:21
my understanding, yes. All right, thank you. Okay, so I just have a
question, too. So this bill, actually, it's different.
I mean, it's a different process than what we're doing with rate
Speaker 164
46:33
reviews as it relates to any other providers. Is
Senator Missy Irvin
Unverified
46:38
that correct? It is looking at a different standard than what we do with other
providers. Yes, ma'am, that is correct. Okay. Do we do this in, I mean, I'm not familiar with any of these outside reports. But this bill has caps on it, like an annual reimbursement cap, which would be qualified for per individual, which
we do utilize for diagnostic, laboratory diagnostic treatment.
Speaker 164
47:06
Yes, ma'am. Is that correct? Yes, ma'am, that's correct.
Speaker 163
47:10
And we currently have an adult dental cap rate of $500 per year. Children have no limits, but adults do currently have a dental limit, hard limit. Okay,
Senator Missy Irvin
Unverified
47:19
so this bill is not touching the children's... No, ma'am. Not their limits. We don't have... Under federal
Speaker 163
47:25
law, we cannot have limits for children, so we do not have any
Senator Missy Irvin
Unverified
47:31
limits for children. Okay, so I guess that's my question for the pediatric dentists because there is no cap.
That's just a reimbursement rate. So this bill may or may not affect you with pediatric dentistry as it relates to children. Do I understand that
Speaker 101
47:51
correctly? There's no cap on maximum expenditure per kid, but this is for a fee increase for each of our procedures.
Senator Missy Irvin
Unverified
48:08
Okay, so that's the second part.
This is the adults with special needs is the cap.
Okay, so that's in the first. Okay, that's just covered in the first part. Gotcha. Yes, Senator Payton.
Senator John Payton
Unverified
48:27
So what is the current cap? I think I heard you say there
Speaker 187
48:32
is a current cap. For adults, yes, sir, there is,
Senator John Payton
Unverified
48:36
and it's currently $500. Okay, so this bill would raise that to $1,000 the first year, $1,250, the next year, $1,500.
So does that cap lower the fiscal impact? No, sir, that
Speaker 163
48:48
actually would increase it because it's increasing the cap for those individuals three times higher. I understand that it would have a
Senator John Payton
Unverified
48:54
net gain in fiscal impact, But when you did these figures, you just took the number of cases times the increase? We took the number that's
Speaker 166
49:02
currently billed for those codes. But some of those could be denied
Senator John Payton
Unverified
49:05
because they've exceeded the cap. But the cap would be raised, so
Speaker 163
49:09
they would actually be able to bill it more. So no, sir, we didn't count for that.
Right, the cap is only for special needs. So that cap is at 500. When we pulled those codes, it's using a cap of $500 for all adults today. The bill as written would increase it for special needs adults to $1,500. So we don't think there would be an increase in denials based on this
Senator Missy Irvin
Unverified
49:34
bill. Thank you. But there is an approval process, correct? There's an appeal process, I mean. Yes, sir. That still should exist, right? For adult dental, there
Speaker 163
49:41
is no extension of benefits right now. We are looking at that as part of our manual.
When we came back over to fee-for-service, we're doing a complete review of our manual, including our prior authorization process, which I think they testified about here, because we know that it doesn't follow what was being done in managed care, and we want to kind of re-look at it, given it hasn't been looked at in seven years. So all of that is being examined as part of that
Senator Missy Irvin
Unverified
50:05
process. Okay, yeah, I would recommend there has to be an appeal process. If you have somebody who has a
really trained rec of an issue that needs to be addressed and fixed, and that may exceed that cap, I think it's important to have an appeal process in there for them.
Okay, thank you. any other questions for anybody at the table from any members? All
right. Thank you. Thank you for the information. All right.
Speaker 196
50:32
Yes, sir. Please. Madam Chair, Dr. Mark Bailey from Waldron, Arkansas. Thank you. I'll try and keep my comments very brief. Thank you. Just a short bio. Practiced in Waldron, Arkansas since 1984. I'm the only provider in Scott County, have been for years, run a mom-and-pop type of dental practice there, and have treated
Medicaid children, Medicaid adults, and Medicaid special need adults, the predominance of that 41 years. And I appreciate the opportunity to speak to the committee today and your indulgence of us in regards to a very critical situation. Because of my aforementioned circumstances, there's not a dentist within 30 miles of me in any geographic direction. I'm the only dentist in Scott County, have been for years. Medicaid reimbursement rates are not only important to me,
it's important to my children that I serve and those special needs adults as well, and it's a pretty critical topic. I get inundated constantly from surrounding areas, all the counties that touch or border Scott County for new patients almost on a daily basis. I'm almost overwhelmed at this point and have had to limit my practice to just seeing residents of Scott County from a Medicaid point of view.
Underserved doesn't even begin to express the situation in many of our Arkansas counties, and I'm a part of that. For small-town practices that operate anywhere from the Oklahoma border to the Delta, we don't generally have practices that, for lack of a better description, cash flow as well as our metropolitan colleagues. And so it presents an interesting operational situation for us.
We run on tighter budgets. There's less wiggle room for us from a profit-loss perspective. And so we are, though, a large part of the provider service in regards to Medicaid dentistry because we live in rural areas that are underserved and perhaps of a lower socioeconomic status. And so it's important for us in that regard. As Dr. Harvard mentioned, our costs have risen astronomically over that time,
especially post-COVID, and we're seeing increases from a 4% to 5% per year average, and that's not slowing down. As an industry, these economic challenges are sort of unprecedented post-COVID, but we are facing not only a serious economic dilemma. My age class, Dennis, is facing what we would consider a moral or ethical dilemma.
On the one hand, do I continue to provide services that I'm doing out of pocket, as was mentioned by Aaron, or do I continue to do the right thing and treat an underserved population that cannot take care of themselves in regards to their dental health needs, especially the special needs adults and the children? And so do I quit taking Medicaid altogether and totally ignore these people, or do I continue to operate at an unsustainable loss for them, and how do I balance that?
And I have to make that decision every day when I look at my schedule, and it is unfortunate. One of the things that I want to point out to the senators is that there's a paradigm shift that's about to happen in the dental community within the state of Arkansas, and it's a statewide problem. The predominance of dental practitioners in the state of Arkansas are 55 or older. If you look at us from a demographic standpoint, just strictly based on age, we're either retiring, we're either transitioning our practices, or frankly, we're dying.
And my age class dentist has historically provided Medicaid dentistry just out of a sense of that's what's best for the communities in which we live. These people cannot help their circumstances to a degree, especially the children and the special needs adults. We've always felt compelled to do the right thing. So fast forward now, the upcoming dentists that are just now graduating, that are buying our practices, are moving into our communities that need to provide these services in an ongoing fashion.
They are saddled with tremendous debt, average debt for new dentists that are just now arriving on the scene that have just graduated is something north of $300,000, probably closer to $400,000, if they buy a practice, now they're looking at an additional debt of a quarter of a million to well over a million dollars to buy a practice. Quite frankly, most of them cannot borrow that money. But they obviously cannot do dentistry for free and pay that debt. And so those young people will be forced
make that decision strictly based on an economic perspective. They cannot do dentistry for free. I've paid for my practice. I've financed my own retirement. I can do dentistry for free. These gentlemen do dentistry for free. But our younger colleagues cannot do that. And ongoingly, they will not do that. And that's what saddens me about this particular situation. And that's what's driving, frankly, the corporate dentistry model.
They can't buy a practice. They're so saddled with debt, they can't move forward. You well know, Senator. And so I've changed my fee schedule probably in this 18-year time span that we're talking about. I've probably changed it on an average of every two to three years. And all I'm doing is widening the gap between access to care. And it really, from a psychological and an emotional standpoint, bothers me because I've been invested in a very rural community for 40 years.
And I don't know what's going to happen going forward. And unfortunately, access to care for probably close to 500,000 kids, there are about 750,000 people eligible for Medicaid dentistry in the state of Arkansas. That's one in four of Arkansans is eligible for this. And so going forward, for financial reasons, it's going to be incumbent
Senator Missy Irvin
Unverified
57:22
Thank you so much for listening to us today. Thank you. I have one quick question. If this rate review
comes out and it's more money than what is
Senator Clint Penzo
Unverified
57:40
in your bill, then what? If it does, I'll have a discussion with this committee and make sure that whatever happens today is still the intent of the committee because I was a little concerned when I heard
that myself because when I'm looking at this, when I'm looking at a fiscal impact, I'm looking at every angle. And right now, we spend over $10 million a year, the rate payers in Arkansas, paying for fluoride in the water, 99.5% of that fluoride goes down the drain, goes on the grass, it goes to industrial uses, it goes to water and chickens and cows and other agricultural needs. And we're 99.5% of that $10 million is wasted on fluoride. When we can have topical
applications to our youth that are under treated with Medicaid, that's how I look at this. I would obviously like to offset it, but I didn't merge the two bills, but that's how I look at things. So we limited this to, you know, disabled adults, not all adults, and children. Those are the vulnerable populations, and that's what I want to try to, you know, the population I want to try to help.
So with that, I know we've got a lot of bills today. We'll go ahead and close unless there's questions. Are
Senator Missy Irvin
Unverified
59:08
there any other questions from members of
the committee? I just thought it was
Senator Clint Penzo
Unverified
59:13
a fair question to ask since we got new information. I'm happy. I mean, if this moves off and the fiscal impact comes back drastically different
and everybody has a different opinion, we can revisit that.
Senator Missy Irvin
Unverified
59:24
I'm totally fine with that. Okay, cool. All right, any other questions from members of the committee? Nobody else has signed up for or against. I think you've closed for your bill, pleasure of the committee.
Motion do pass. Second. All those in favor say aye. Aye. And opposed. As have it, congratulations. The bill passes. Thank you, Senator. Thank you for the discussion and the ability to have the discussions. I think it was really good information and very important. And I'll just say from a personal point of privilege, I mean, yes, I filed the disclosure. I just wanted to make sure everybody understood. I have two disclosures. I have two sons in dental school. Well, one that's graduated, one that's currently in dental school.
And then my husband actually does do the topical treatment of the fluoride, which is reflected in this fiscal impact statement. So I just wanted to say that I do believe that our Medicaid program should be entirely focused on health care. And I think there's a lot of spend outside of health care, direct health care in our Medicaid program that should be attacked. But I appreciate the bill and the conversation. And I
hope that in continuing conversations with DHS, if that does come out, we'll go from there.
Speaker 196
1:00:39
Thank you. Madam Chair, may I interrupt just for a second? I sent you an email on March the 6th. I sent each one of you in support
Speaker 47
1:00:48
of Senate Bill 347. If you have any further questions, just email me.
Senator Missy Irvin
Unverified
1:00:54
Thank you. I believe that the Dental Association, though, is still for fluoride. Would that be a correct statement?
Thank you. Senator Ludding, we're going to go to 587. That's our other special order
that I have listed. And then we'll go right back to 311.
Senator Penzo will let you catch your breath and get ready for the next bill. We'll toss to Senator Ludding.
I'm sorry, we're at 587. Well, thank you.
Let's get you. If you'll state your name for the
Senator Greg Leding
Unverified
1:01:59
record, you may proceed. State Senator Greg Letting from District 30 in Fayetteville, and I'll let my guests introduce themselves
Speaker 216
1:02:07
as well. DEBORAH STEWART: Hi, I'm Debra Stewart from Austin, Texas. Sorry. DEBORAH STEWART: Thank you. Please proceed.
Rhonda Finley
Unverified
1:02:14
RONDA FINLEY: I'm Rhonda Finley. I'm a lifelong Arkansan, but I come to you via
Speaker 220
1:02:32
of my mother. DEBORAH STEWART: I'm Betty Finley. Good morning, Senators. Like I said, I'm Betty Findley. I'm 87 years old. I was born, schooled, married, children, right here in Little Rock.
My adventure is right here. I've never left. I'm proud to be an Arkansan, and I'm very proud to be an American. Thank you. Madam Chair, Mr. Vice Chair, members
Senator Greg Leding
Unverified
1:03:11
of the committee, and good morning to everybody watching online. Ms. Finley reached out to me back
in October after learning that way back in 2015,
I ran legislation similar to what is before us today with Senate Bill 587 because they, like a lot of families, want to keep tabs on their loved ones. Ms. Finley here lives here in Little Rock, as she said, but two of her daughters also live out of state, and they, like a lot of people, just want to be able to keep better tabs on their families. That's a common thing to all of us. And so one way they would like to be able to do that is by placing a camera in Ms. Betty's room at the facility where she resides. We have cameras just about everywhere. There are two in this room.
We all walk around with a camera in our pocket. There are, at many daycare facilities, you will find cameras. And at many facilities where you are allowed to board your pets, you will find cameras so that you can check in on them while you are traveling. We do this to bring peace of mind to families, and we see that there's no reason not to be able to provide families that same peace of mind when it comes to their loved ones living in long-term care facilities. The way Senate Bill 587 would work is that the cost of this technology would be borne entirely by the family.
There would be no cost to the facility. The residents obviously would have to consent to having this device in the room, as would any other person living in that room with them if it was a roommate-type situation. Again, many of these facilities already have cameras throughout. We are just asking that the families be able to have the peace of mind of being able to have a camera in their room. I believe that legislation similar to this is already law in 16 states. And in many of those states, studies have shown that the financial liability for these institutions is actually lowered by the presence of having these cameras in their rooms.
And with that, I will turn it over to the family to let them
Deborah Stewart
Unverified
1:05:06
say what they have to say. Thank you. I'll go first. My name is Deborah Stewart, and as I said, I live in Austin, Texas. So I have a lot of distance between my mom and myself that, you know, I don't really like, but when we, when she first moved into a facility, and also I might add, this is my second parent to be in a long-term care facility.
It's not ideal, not where anyone actually must end up, but many of us find that that is the reality, and that is the reality we face every day. We check on our mom. We visit as often as possible, but just the distance requires, you know, she has a phone. We can call her. But we were first allowed to put a camera in the room when she became a resident at a facility here in Little Rock. And then at some point along the way, we were told that they were not allowing it anymore.
We could keep the camera. And then we've been recently told that at some point we will have to remove the camera. I would say it has been a blessing to our family to have that level of communication with our mother that is not the same as a telephone. She wants the camera there. There are cameras all over the facility. And yet, for some reason, if you want to have a camera in a room you're paying for, out of your pocket, that by state regulation is not allowed
if the facility does not allow it. And so I had looked into, in Austin, I called several facilities because Texas passed that legislation some years ago. And what I was told by just the canvassing that I did, that, as it turned out, cameras, resident cameras have never been an issue. Once it was allowed, it has been, one facility told me, there are literally a thousand cameras in this facility.
The room cameras have never been an issue. The costs are borne by the residents and their families. The consent is given by the resident or someone with power of attorney for the family, and that in most cases, the states that have allowed this legislation have used that model. There are several pending state bills in other legislatures as well right now.
I would just say, just understanding that when you reach this point in your life, It is a vulnerable point, and it is important to be able to communicate as much as possible with your loved one in the best possible ways. And if having a camera there actually reduces liability, as it turns out, insurance rates in the studies that I've read, Fordham University did one, the rates went down in those nursing
homes because they had less problems in the facility. Once people recognize that your behavior, if that's a problem, and in most cases it isn't by the employees of the facility, but when you have that camera, it is just an extra level of protection, and it protects the facility as well from any kind of accusation that may be false. It works both ways. It's a two-way street. So the world has changed since 2015, and Senator Letting brought this
bill before. The world has changed. There is a camera. Literally every building you step into, parking lots, there's just not a place. I'm looking at the camera that I'm on right now and the one behind me. So to say that someone in a nursing home cannot have a camera in the room if the family wants it and the resident wants it. It's just sort of the fears based around that have sort of been, have gone away. And we just are, it's a world we live
in now. So I'll pass on to my sister. But thank you for listening today and understanding where we're coming from. It is important to us. It has changed our lives in a positive way. And we hope for everyone in Arkansas, it will be the same. Hello, senators. My name is
Rhonda Finley
Unverified
1:09:47
Rhonda Finley, and it is truly an honor to be here today. Ma'am, give
Senator Dave Wallace
Unverified
1:09:52
me one second, please. Sure. Senator Love, you have a question?
Senator Fredrick J. Love
Unverified
1:09:56
Thank you. And so, I mean, I guess the biggest issue, I think, facing with this bill is the fact that if you share a room, and I understand within the bill you said that the other person has to give consent, but I think that that's kind of the biggest issue facing this bill. I think that's it. And so, how do you, if someone says, hey, I don't want this camera in my
Speaker 120
1:10:37
room, how are they going to resolve that issue?
They just don't put the camera in the room?
Senator Greg Leding
Unverified
1:10:46
Yeah, if not everyone in the room consents to the presence of the camera, the camera would then
be removed. Wait a minute, you said it would be removed. Right. It does require consent. Well, if, like, somebody consents at the beginning, but they change their mind. Right. For the camera to be in the room, everybody would
Speaker 120
1:11:08
have to consent at the beginning. So they consent before the camera's put in. Correct. Is that what you're saying?
Chair
Unverified
1:11:13
Yes. Okay. All right. Thank you again, sir. Thank you again. I just didn't know if Senator Payton had a question. Hold
Senator John Payton
Unverified
1:11:23
up one second. Senator Payne, you're recognized. Thank you. I
just wanted to go ahead and get in there because you may can address this in your testimony, but what's preventing
it now? Is there a law that says they can't do it, or is it just the business owner or whoever owns the nursing home that says you can't do it? What's preventing
Speaker 188
1:11:43
it? Right now the facilities have the option to tell residents that they simply can't have a camera in their room.
Rhonda Finley
Unverified
1:11:48
Okay, so this would compel them to do it. Correct. okay
Speaker 239
1:11:59
thank you so you can go ahead thank you senator um so first of all i was looking around the room senator hill senator flippo senator payton senator love none of us are getting any younger truth i was looking back here i saw these faces and i realized that you all didn't realize that this regulation exists, that you cannot, right?
It affects every single Arkansan. And I was listening to the dentist. I was completely compelled by the group that previously spoke. They talked about giving treatment as a moral dilemma for them under their circumstance. I know y'all were all listening. This is a dilemma for every single Arkansan that wants to age in place.
Speaker 242
1:12:53
You think today it doesn't have anything to do with you or you or you? It has everything to do with every single person, including the nursing home lobby, which is a hell of a lot stronger than my spoken word. But today, we are faced with a moral issue here and a rightful issue to allow you to place a camera in the space that you pay for to assist in what is a triangle of care.
The patient that either has or has not the ability to speak up for themselves, for the care facility, which is going above and beyond in many instances to provide care, and for the family that exists that wants to participate in the long-term care plan. And if anyone in here is friends with lobbyists for the long-term care industry, we know that absent one point of contact in that triangle of care could mean that, Senator Love, one
day you don't have the care that you are promised. And this is a promise to help the facilities maintain the highest level of care while reducing their liability. This is to allow in our global society, Arkansans that have been able to move to another state, state connected. This allows us all to look out for the most vulnerable members of our community and to continue to participate as family members.
This is a bill that is a permissible bill. Permissible. And I would dare say, as we look around this room, it's to help everyone. So while we're worried about care, this is an overlooked piece of the puzzle. It has allowed us to work very closely with the care facility that my mom is in and to get great results. And as a matter of fact, it was a tool that the administration of our care facility was able to use to then up the seminars and care training for their people.
This is not a negative. This is one of the most positive bills that can move through. and I ask you all to vote to support it, to take it to the full Senate floor so that every person in Arkansas that sent people to the Senate, we can have a full discourse tomorrow about it, and then possibly have more one-on-ones for interested parties that might be fearful of this to actually allow us to show them where, in some cases with the nursing home
industry, it will reduce their cost and liability. And I think that this is great legislation for Arkansas, and I hope that you can see it
Speaker 220
1:16:03
and support it. I would appreciate it. Thank you. Good morning again, Senators. I'm Betty Finley. I'm 87 years old. I was born and raised in Little Rock,
And I'm a very, very proud Arkansan.
Speaker 244
1:16:20
Today, I stand, pardon me, I sit before you. And not just as an 87-year-old woman, but as someone who cherishes the beauty of life. And the privilege to speak to you about this important element of long-term care.
Eighty-plus year olds like me and folks of any age that need a facility that provides care 24 hours or a vulnerable community here in Arkansas, I understand that you are trusted by us to make decisions to protect our health and well-being. Today, I ask you to allow me and my peers of long-term care to make our own decisions
to monitor activities in our rooms. This is our home, and I pay for that privilege. I believe it's essential to discuss the importance of allowing residents like me me to have cameras in our nursing home rooms. Having our own cameras in our rooms that we take care of promotes transparency and trust with my facility, caregivers, and my family.
Cameras which are around us in child daycares, for example, provides reassurance to families their loved ones are safe and well cared for. By seeing glimpses of our daily life, concerns about our well-being can be alleviated. In closing, permitting cameras in our nursing homerooms is about fostering connection, emotional health,
and trust. I ask you to permit this for all Arkansans and future generations. Let's embrace technology in Arkansas and protect Arkansas seniors. And Senators I thank you for the privilege of speaking to you today and I hope that you will hear what I have to say and vote favorably for what I'm asking you for. Thank you.
Speaker 149
1:19:17
Thank you very much, members. Are there questions from the committee? All
Senator Scott Flippo
Unverified
1:19:24
right. Seeing no questions, do we have anybody signed up to speak? We've got Ms. Rachel Bunch with the Arkansas Healthcare Association going to be speaking against.
Senator Missy Irvin
Unverified
1:19:47
Thank you. If you'll just state your name for the record, please.
Rachel Bunch
Unverified
1:19:53
Sure. Good morning. My name is Rachel Bunch. I'm the Executive Director of the Arkansas Healthcare Association. We represent a total of 302 facilities in the state of Arkansas. Those include nursing facilities, assisted living facilities, and intermediate care facilities for those with developmental disabilities. And our association is opposed to this bill. I'd like to add, before I talk about what I prepared today, just a couple of comments and what went before us.
So we do have a number of facilities in Arkansas that allow for cameras in the room. So that's changed over time as technology has progressed. When this bill was filed, I did a quick poll of a number of our members, and we have an increasing number of facilities that are starting to do more of this. We still have a lot of facilities that in their policies don't allow it. A lot of them that do offer this to their residents, they do it differently. And our position is that we'd like facilities to be able to decide how to do this and what's best for them.
So there are some facilities that allow family members of residents to put cameras in rooms, but there are a lot of logistics and issues with that and how you do it. There are a lot of different concerns. Also about communication, we think that family members and communication is, of course, important and encourage that constantly. Facilities do lots of FaceTime phone calls. There's lots of communication that our member facilities, that they will facilitate for those family members.
There are lots of ways to talk to families and have them, you know, if they're not able to come in the building. Our biggest concern with this bill, as written, is we think it's an insult to dignity. And we have a lot of concerns about residents' rights and privacy. We do have cameras all over this building. I've got a camera right in front of me. I've got a camera on my phone sitting right here on the table. There's not a camera in the bathroom. There's not a camera in your office. The facilities, most of them have cameras in common areas, which is actually a part of HIPAA.
Hallways, dining rooms, day rooms, things like that. But a facility, a nursing facility, someone in their patient room is a very different situation. We think, you know, the residents that live in nursing facilities, they live in their rooms. Some residents are more mobile than others, able to move around. They live in their rooms. These are rooms where people get dressed, bathe, receive food, medication, talk to their nurses, talk to physicians, talk to other providers. There are a lot of private conversations and things that happen in their beds, in their bedrooms.
And constant surveillance over those people in their bedrooms infringes on their right to privacy. A big concern that we have with the bill, I think it's on the second page, where it talks about the authority and the consent. We think that the wording here is problematic. If you look at the bill, it says the resident, it defines a resident representative without detail. So the way that we read this bill, it does not restrict this right to those that have authority given by the resident to make health care decisions on their behalf for the resident.
But it's over the person appointed by a court. It broadly defines a resident's representative with authority to authorize monitoring, even over a resident with capacity to make their own decisions. So the way that this is written, if my mother were in a facility and my mother had the ability to make her own health care decisions, but I wanted to place a camera in her room, it implies that I would be able to do that even against her wishes. And so it has this definition here of a patient's representative, but it doesn't define that.
Is that a friend? Is it a responsible party? Is it a guardian? A POA? A family member? What about siblings who don't agree on if this is going to happen? You could have a lot of family discussions and issues with this, and the bill does not define any of those things. The next thing I want to talk on briefly is about roommate and privacy considerations. I know Senator Love asked a question about roommates. You all recall a couple years ago we came before you with some rules to update the way that patient rooms are done in nursing facilities
because as our industry is trying to promote more private rooms, that doesn't happen overnight, it isn't free, and it's a long process. However, around 80% of rooms in nursing facilities in Arkansas today are semi-private rooms and they have a roommate. So the process for dealing with roommates, making those considerations can be tricky and difficult. There's already a lot of considerations and things to think about putting two people together in a room where these people spend a lot of time.
For residents that live in semi-private rooms, the ability of the roommate to refuse consent, the constant surveillance is in question. If the roommate refuses to consent, one of the residents is required to move. This is unfair and coercion of a resident and will result in bullying of residents by other residents or their families in order to obtain this agreement. Similarly, if a resident moving into a room already under surveillance is required to consent to this surveillance, if they refuse and no other rooms are available, then the resident's right to choose the long-term care facility that they want to reside in is negatively affected.
Again, about common areas, recording residents on facility cameras in common areas is supported by HIPAA. The facility, as a covered entity governed by HIPAA, may utilize cameras in common areas when there's no expectation of privacy by the resident to enhance delivery care systems and reporting. Facilities do not ever place cameras in resident rooms under any circumstances. As I said, they might have them in dining room, day room, halls, entryway, the door,
but not in patient rooms where they have the expectation and right
Rachel Bunch
Unverified
1:26:09
believe that this is an insult to friends, medical professionals, and clergy that are in these rooms visiting patients. We think this would reduce the willingness to visit and to serve. It also ignores the privacy rights associated with these conversations, particularly at the end of life, physician-patient privilege, and clergy privilege. It could also inhibit some of these conversations that are very important and need a lot of privacy.
Another thought that we had, why is there no similar requirement proposed for hospitals, hospital rooms, in homes of residents receiving skilled home health services? What about patients receiving dialysis services? There's no data to support that implementing these devices in healthcare environments is beneficial to patients. Finally, a couple of questions about the footage and who owns this footage. What happens to this audio and video footage? You hear about baby monitors being hacked, about video footage, information that's out there that may not be secure.
Who would be allowed to record the video and audio? Can it be sold? Is it a crime if it's sold? Is it a crime if it's shared? Could permission to watch or listen be granted to others? How will that be documented and how is that determined? Happy to answer questions. I think that covers the majority of my remarks. Are there
Senator Missy Irvin
Unverified
1:27:35
any questions from members of the committee? Senator Love, you have
Senator Fredrick J. Love
Unverified
1:27:39
a question. Thank you. Because I was trying to keep up with your notes. We're in the build. You talked about the person having to move out of the room. We're in the build. Let me just a second. So page
Rachel Bunch
Unverified
1:27:58
three, line 27, it says three, nine 27. If a resident residing in a shared room or his or her representative does not consent to the use, the facility shall accommodate the
resident or representative by moving one or more of the residents to different rooms. That may or may not be available. Those roommates may get along with each other. I mean, we think that's problematic.
Senator Missy Irvin
Unverified
1:28:24
All right. Thank you. Are there any other questions of the members of the committee? I
see none. Thank you for your testimony. Also, we have Greg Worthen. Okay, Joel Landrieu.
Speaker 260
1:28:47
Against. Good morning, ladies and gentlemen of the committee. I'm Joel Landrieu. I am the executive director of the Arkansas Council for Behavioral Health. We represent a number of different mental health providers, some of them including psychiatric residential treatment facilities for children. And I stand before you in opposition to the bill as it's currently written, because I think it's a well-intended bill that has unintended consequences. Also on your agenda for later consideration is House Bill 1653, run by Representative
Kavanaugh, and that bill seeks to strike psychiatric residential treatment facility from the residential child care definition and put it into the long-term care facility definition. This bill would apply to everything licensed as a long-term care facility. So if 1653 passes, then you're going to have patients who have a right to put cameras in the bedrooms of teenage psychiatric patients because these are long-term care facilities. And I don't think that cameras in the bedrooms of teenage psychiatric patients is where we
are today, and I don't think it's where we need to go. So I would ask that you would vote it down or ask for some sort of amendment that allows for an exception to the different types of facilities. In response to Senator Love's question about room reassignment, that actually would be very problematic for some of our facilities, which are rather small, 28 beds or less. And you already have a lot of considerations that have to be taken into account in who to pair up with whom.
So if you've got the consent, non-consent question in an additional complication in how to pair up people with rooms together, you've just made running that facility that much more difficult. Yes, we have cameras in common areas. No, we don't have cameras in bedrooms where people dress, where people bathe, where people have private conversations, where people masturbate. There are privacy considerations that I don't think this takes into account just because it might make sense for certain nursing home patients. And I would urge you to not adopt
Senator Missy Irvin
Unverified
1:30:57
this in its current form. Thank you. Are there any
questions from members of the committee? Okay. Thank you. I apologize for mispronouncing your last name. Sorry about that. But thank you for your testimony. Any, I think, DHS? Is DHS in the room? Okay, anybody else here to speak for or against the bill? Please come forward.
Did you need to speak against or for the bill? No, okay. All right. You're recognized or closed for your bill. That's
not appropriate. Sorry. Thank you. Thank you, Madam Chair,
Senator Greg Leding
Unverified
1:31:52
and thank you, committee, for your time and consideration. I do just want to point out a couple of things
that we are talking about with this bill.
We're talking about living facilities and not health care facilities. We also know that in many of these places, residents, if they are looking for something to be done in a private manner, they have conference rooms where they are able to do what are known as care meetings or one-on-ones. I know we heard a discussion of dignity. We do believe that this is about dignity, the dignity of people being able to stay in touch with their loved ones and not be denied that opportunity because we believe that that is something that we all desire and want to have.
That said, based on some of the conversations, and it is not our intent to open this up to people who we are not intending to cover under this, we are willing to consider amendments to this legislation, but also would love to have a conversation with the nursing home industry and see if we can't craft a piece of legislation that we could all agree that would meet the needs of being able to give parents and their families peace of mind. So with the committee's permission, we will pull down this bill to consider amendments. Thank you. Okay. Thank
Senator Missy Irvin
Unverified
1:33:02
you. Senator Penza, Senate Bill 311. And you have a handout. Thank you, Senator Letting. Thank you, members, for the testimony
on the bill. I believe you had somebody fly in today. Yes. We're happy to have you with us. You just state your names for the record while we're passing out your handout. My name is Robert Fulham.
Senator Clint Penzo
Unverified
1:33:33
Happy to be here as well. Clint Penzo, Senate District 31, Springdale.
Okay. Do you mind if he goes ahead and starts while we're
Speaker 271
1:33:51
handing out the... Go right ahead. Okay. Good morning and thank you for the opportunity to speak in support of SB 311. I just want to start by saying the views and opinions expressed are those of myself and do not necessarily express the official policy or position of my employer.
The field of genomics is still in its infancy. The much bubble-sized first human genome was only completed in 2003 and at the cost of over $2 billion while taking a decade to complete. In that time, it was also laden with gaps, so there were errors of genomic sequences that we could not parse. Fast forward to today, a person's genome can be sequenced within hours and at the cost of just hundreds of dollars. And so called tip-to-tips -- Can
Senator Missy Irvin
Unverified
1:34:35
you just speak right into -- sorry, speak right into that mic.
Speaker 271
1:34:38
It's really loud out there. Sorry. I apologize. Oh, yeah. Absolutely. Tip-to-tip sequencing has filled in previous gaps of unknown sequence. These are tremendous feats, but also they represent only the beginning of the journey of genomic-powered medicine. The true challenge would be our ability to decipher this new genomic language within our genes. How these genetic grammars affect our physical features, our health, and our personalities. In these endeavors, there is the potential to conquer devastating diseases, tailor treatments
to patients' personal genomes and fortify our crops from drought and pests. In a perfect world, humanity would labor together to make these genomic dreams a reality. In reality, hostile nations, most notably China, have dedicated significant resources to the illegal theft of our scientific and technical knowledge for their own authoritarian desires. Everything from our citizens' financial information or telecommunications, even the
proprietary composition of our soda can linings, have all been targets. Chinese business entities are by law mandated to cooperate with military and intelligence agencies in gathering this data. In response, the U.S. has taken prudent steps to protect our interests, such as the banning of Huawei telecoms infrastructure that could be used for spying and data collection. This proposed bill here is a necessary continuation of this policy to safeguard the data of our
citizens. BGI, the leading Chinese genomics company, has already shown its willingness to leverage its genomic sequencing technology for nefarious purposes by participating in the genomic surveillance of Uyghur minority Muslims within China. Our genomes are the most intimate data we have, the very building blocks of our being, and while the tantalizing potential of genomic medicine is great, its unethical applications are equally concerning. From the truly dystopian potential of advanced bioweapons to the more
mundane illegal harvesting of our data for Chinese commercial benefit. Based on the ample evidence of Chinese worldliness to gather U.S. data by any means, and the complicity of BGI and state-backed genomic surveillance, it is past time that action was taken to block the use of BGI sequencing technology. Arkansas should not wait on the federal government to take these actions, and as such, I support the passing of this bill. Thank you for your time, and I'm happy to answer any questions. Thank you.
Senator Missy Irvin
Unverified
1:37:15
Could you just go through for me and just explain the bill, just in layman's
term as to what you're trying to accomplish here. I
Speaker 271
1:37:27
mean, I appreciate that. I just. Yeah, so this bill, I know several amendments have been introduced to ensure that this is not going to be overly disruptive to current healthcare within the state. But what it seeks to do is prohibit the procurement of new sequencing platforms from hostile foreign nations, by far
most notably is China. They have a company, BGI, which is competing with Illumina and other domestic U.S. sequencing companies. And they've also set up several U.S. subsidiaries. So this company has a track record of a willingness to work with Chinese, essentially repression of weaker Muslims within China. And so, this is the type of company that we want to be
buying their equipment when there's the potential for them to make nefarious uses of it. What's the name of the company
Senator Missy Irvin
Unverified
1:38:41
again? BGI, sorry, BGI Genomics. Okay. So
Speaker 271
1:38:45
how is this affecting Arkansas? So, you know, genomics is increasingly moving from just the lab to the bedside. You know, genetic testing and genomic sequencing has more and more clinical applications.
So this is now a healthcare problem as well as just like a research question. So when hospitals are making decisions on what equipment they're going to buy, as is the case with many other industries, Chinese companies are often, with state-backed support, trying to undercut U.S. companies, and so they may be tempted to choose BGI or other Chinese companies for their sequencing platforms that can be offered for cheaper, but it is,
in my opinion, an irresponsible decision to entrust that Chinese company to safely handle the most
Speaker 276
1:39:46
private of patients' data, which is their genomic information. Okay. Thank you. Are
Senator Missy Irvin
Unverified
1:39:56
there—Senator Payton? Thank you, Madam Chair.
Senator John Payton
Unverified
1:40:00
So, I mean, basically, you're saying that these foreign adversaries, because they supply the equipment for the testing, could have access to the data that's unintended.
Speaker 271
1:40:14
Yeah, so this is a, it's why I included the Huawei example. The potential is there because these companies are mandated, again, by law to cooperate with Chinese state-backed, you know, data gathering effort. How exactly does this bill stop that? By banning the use of the sequencers, you know, the purchasing of the sequencers, as well as their software. So these sequencers are connected to the internet. They receive software updates. There's the potential for nefarious updates to try to exfil data. And
also, a big revenue source for these companies is the services that come after the sequencing, where they will have a cloud analysis environment, and they say, okay, we sequenced your data. Put it up into this cloud environment and we'll help you analyze and make sense of it. So that would also be another source of concern, you know, is them pushing, you know, U.S. citizens' genomic data to a BGI cloud where, you know, there would be ample opportunity
Senator John Payton
Unverified
1:41:22
for it to be, you know, misused. So at the bottom of page two, section C there,
line 33, I mean, that paragraph seems to say that we're going to flush any machines we currently have and replace them. Is that the intent? We'll page more. The bottom of
page two, section C, starts on line 33, says, all genetic sequencers and operational and research software used for genetic sequencers prohibited under this section that are not permanently disabled shall be removed and replaced with genetic sequencers and operational and research software
that is not prohibited. So we're basically
saying we're going to flush whatever's already out there that's under this ban
Speaker 271
1:42:08
and replace it? I think there was an amendment that was being considered that would just simply prevent future purchases and not
Speaker 140
1:42:18
any... We worked with UAMS on that language. So my question was going to be how much of it's out there
Senator John Payton
Unverified
1:42:27
and what's it going to cost us to
Speaker 271
1:42:34
throw it in the trash and replace it? Yes, again, I think there
Senator John Payton
Unverified
1:42:43
will... The paragraph allows them to ask for a reimbursement from the
Senator Clint Penzo
Unverified
1:42:51
state, I guess. I know that we'd worked with UMS on the language and they ended up being okay with this draft.
Senator John Payton
Unverified
1:42:59
So maybe they added the reimbursement, but I don't know. I think we need to know what that's
Senator Missy Irvin
Unverified
1:43:09
going to cost. I'm sorry. Could
Senator John Payton
Unverified
1:43:12
you point to that section again? The one I'm talking about now is top
Senator Clint Penzo
Unverified
1:43:18
of page three. Let me reimburse me. If I may, Senator Payton, that amendment hasn't come through yet. That was my bad. We just wanted him to testify today since he was in town.
That amendment still needs to be sent down. I thought it had already been done on this because we've made other amendments to it, and I thought that had been incorporated into this version, and it has not yet. So that will be corrected. Okay, let's go ahead and pull the
Senator Missy Irvin
Unverified
1:43:50
bill down then until we get that amendment. Yeah, unless
anybody's got any additional questions while he's in town. Does anybody have any questions for him? He flew in today. So any additional
Senator Fredrick J. Love
Unverified
1:44:03
questions for his testimony? Senator Love? Okay, so I think I understand, but I didn't follow you initially in your testimony,
but let me answer this. So we're trying to prevent, what is this information being used
for, I would say? What is this information usually being used for? Yeah, so it depends, but... Well, what can you
use the information for? I mean, because we're trying to prevent it from falling into
the wrong hands, so how are you saying the information is being used when it falls into the foreign adversaries' hands?
Speaker 271
1:44:43
Yeah, so there's the potential today to do some concerning things. You can, the use of American genomic information can absolutely be used by nefarious intentions within China to develop targeted bioweapons. I believe in the dossier that was shared, there are senior military officials within China who have publicly discussed this possibility.
And then it can also just be like the vast majority of intellectual property theft that occurs from China. It can just be used to outcompete our domestic firms to bring genomic treatments to market by essentially stealing this data. And then the third thing I'll say is it is a young field, and in many ways we don't know know yet what the full implications of people's genomic information will be.
There are thousands of genes that we still don't understand the functions for. And so if we do not safeguard this data today, there's a level of concern with
Speaker 276
1:45:59
what can be done today, but there's the potential for far greater concern in 10, 15, 20 years.
Senator Clint Penzo
Unverified
1:46:08
There's a lot of protections that need to take place with our genetic information. The one reason I've never done like a 23andMe is because in the fine print, they have your
access. I mean, they have the rights to your DNA at that point, so I've never done it. I would like to see some legislation in the future that protects it on that level. Huh? You won't be here to help, so okay. But that's a whole other thing, but we need to make steps. There's backdoors in this software that allows, could allow them to access and make a database of every American's genetic code and who knows, like he said, where this could go in the future,
whether they could, you know, give you something to trigger certain genes or that are currently dormant. There's a lot of stuff out there with genetics we fully don't understand at this point. I believe in our digital privacy. I've got a bill for that, and I believe in our genetic privacy as well. So that's the main reason we have this bill. We've got the amendment. I just got word it's coming over, but we're not going to hold this up now. We'll try to revisit it. When the amendment gets here, it wasn't ready until just now.
we'll go ahead and pull this down unless there's any additional questions.
Senator Missy Irvin
Unverified
1:47:36
Okay. Sounds good. Appreciate you. I mean, we're coming back this evening, too, so once the amendment gets here, you
Senator Clint Penzo
Unverified
1:47:42
can... And I do have folks in town for 219 as well, but we'll get to it whenever the chair says good. Okay, well,
Senator Missy Irvin
Unverified
1:47:49
I think Senator Letting has somebody also that has flown in, so I'd like to go to him next. Thank you.
Senator Greg Leding
Unverified
1:48:01
You say what bill? State Senator Greg Letting, District 30 back in Fayetteville. All right, Senate Bill 507.
Ron Cook
Unverified
1:48:32
My name is Ron Cook. I'm a native of Searcy and currently live in
Speaker 286
1:48:38
Maumelle. I'm Mary Ann McIntyre. I live in Bentonville. I've been in Arkansas about 25 years now. And thank you, Madam Chair,
Senator Greg Leding
Unverified
1:48:46
members of the committee. This bill is a little simpler and more straightforward than the last one. Mr. Cook first reached out to me. at least 18 months ago, or
more, about his son. Mr. Cook is a resident here in central Arkansas. His senator is Senator English, a co-sponsor of this bill. But his son is a constituent of mine
back home in Fayetteville. And his son was receiving these behavioral analysis services that were beneficial to him. And I'll let Mr. Cook explain more there. But there is a rule that says once you turn 21, these services are no longer provided. And we feel as though that restriction is somewhat arbitrary and that these therapeutic services are beneficial to our Kansans and should be available to them beyond that time. So what we're doing here is just simply removing that age cap for these services. And with that, I will let Mr. Cook share more about his story.
Speaker 289
1:49:38
Thank you for being with us. Thank you, Senators, for the opportunity to share on behalf of and in support of this bill. My son has a diagnosis of autism, and he also is served by Arkansas Medicaid's CES waiver, which is an important part of this bill. This bill is designed to be fairly simple and straightforward. It's intended to be rather narrow, and it's a targeted audience, those that would qualify.
It's also noted that the services that it's presenting and allowing would be under medical necessity, and so I hope that you'll take consideration of the positive nature of this bill. My son has benefited by the Applied Behavior Analysis Therapy Services, often called ABA therapy services for a number of years. And as Senator Letting has said, when he turned 21,
Arkansas Medicaid discontinued providing that therapy. And unfortunately, based arbitrarily on his age, he's a good case example of a person who, even as a young adult, is benefiting by this therapy. Now, if you and I want to go see a counselor, we're going to probably participate in what is called a layperson like myself would call cognitive-based
therapy. But a person who has cognitive disabilities does not benefit by that therapy. And so ABA therapy is specifically targeting behavior and it's proven through evidence-based research that it's effective. Certainly been effective for my son and so his experiences of growing and maturing and developing coping skills as a result of this therapy certainly correspond to the research that's there. So we'd like to see this bill move forward in your committee
with the support that Arkansas Medicaid would be directed to pay for this. Now, this ABA therapy is not new. Forty-two states already cover, through their Medicaid program, ABA services for adults. And so we're an outlier in regard to covering these services for adults with autism. Florida is a pretty specific example. They've been doing this for over
three decades. Their services for adults on the Medicaid CES waiver is much more robust and covers a much broader audience than what this bill proposes, which limits it to persons in the CES waiver who have a diagnosis of autism. But Florida is a good example of validating the importance of this, the legitimacy of this therapy for this particular population group.
I want to speak on behalf of my son, who would say that he's benefited by this therapy, and he has asked his care coordinator with his past, when am I going to get Dr. Spiker back, or whoever the therapist was. And so this is important to him, and I know it's important to a very narrow, limited group of Arkansans who can benefit by this. This is really for people who are on the CES waiver who want to live at home and in community. They qualify to be institutionalized
in a technical policy level, but they want to live at home. They want to live in community. My son has been able to grow through this therapy. He's been able to hold a part-time job at a Chick-fil-A in Little Rock and in Fayetteville for now five and a half years because of the support of this therapy. He's been able to take part-time classes at the community college in Northwest Arkansas. His direct support professionals that he has in his life to help him
have all been aided through this therapy coaching that they've received in support of my son. So I hope that you'll take a look at this bill and find it a useful investment. There's going to be concern. Some of you, when I've talked to you, have said, well, what's it going to cost? And the costs are going to be rather limited, arguably, because the target audience is a limited audience. And I would also suggest to you that the state of Arkansas is going to recoup costs through
this preventive intervention therapy, and I'll give you an example that's kind of close to home for me. The therapy's going to reduce the number of, in many cases, the number of first responders, the number of ER visits, the ambulance rides, the number of acute care stays, all of which are charged to the taxpayers at a premium. And so this is an investment as much as it is an expense for the state of Arkansas.
And the result of this investment is a person who is a participating member of the community, potentially a taxpayer. And so I hope that you'll see this bill as an investment in a small group of Arkansans who would qualify and who will have a quality of life as a result of the support that you can give here and letting it get through your committee. Thank you for the opportunity, senators, to share today.
Senator Missy Irvin
Unverified
1:55:48
Thank you. I'm going to turn the chair over to Senator
Flipoff to go run a bill. I'll be right back. I appreciate it. My only question is, should this be limited to just folks with autism, or are there other people that this may should apply to that also enjoy or
Speaker 290
1:56:06
have the services for behavioral health? That's a great question. In many states, it began with autism, and some states have added other entities, other IDD, that are medically necessary.
Speaker 291
1:56:18
Okay. Most states have started with autism, and I'm going to talk about that in a minute. Okay,
Senator Missy Irvin
Unverified
1:56:24
and I apologize. Senator Filippo is going to take the chair. Thank you for
Speaker 290
1:56:33
answering my question. Sure. It's my pleasure to be here. I haven't been in this room in
Speaker 288
1:56:39
a while. I work for the State Department of Ed. I was one of the coordinators over the behavior consultants, which meant we dealt with very challenging adolescents and children. And so I have spoken before in these situations specific to autism.
I always tell people my career kind of parallel to autism. I'm a Tennessee native. We lived in five states. I always said I did autism when autism wasn't cool. Okay, if you know Barbara Mandrell, that's her story too. People ask me, did you choose this life? I said, no, I think it chose me. In grad school, I was interested in people that had the highest needs. I was a speech path for a number of years. I've been a board-certified behavior analyst for 11 years. I have a lot of hours above a master's degree, as do people who are board-certified behavior analysts.
I'm speaking on behalf of the people who can't speak for themselves. Because I have such a long career, it pays to be old. I've seen children benefit from services. I ran Vanderbilt's autism program in the 90s. We didn't have a program then either, and that was a big research hospital. Started a program for early intervention. Many of you know that story. So in the 90s, when autism took off, states started to figure out what should we do about children.
So children were addressed first. It took a long time to get all children the services that they need in the U.S. In the meantime, all those kids grew up. The biggest wave of autism was in the 90s. Those kids are adults now. Unfortunately, many of them are in institutions still because they're not able to live at home or there's no place for them to live, and many of them need specific methods of learning skills either to live or to be employed.
And without that, they're kind of at an end. So, unfortunately, different than other types of illnesses, when you turn 21, your ability in Arkansas, some states, most states it is, that remain in that remaining eight that don't serve adults, it cuts off at 21. That means that some parents have to go home to take care of their kids because there's no one, they're not going to school six hours a day. There's not services for them that allow them to work.
So not only do you have adults with autism that are not getting services, you have old families that are affected. 80% of adults with autism still live at home in their 20s. Many of those are employable. A lot of those never get a job. 40% of them actually never got a job. That's the 2024 statistics. I don't think it's gotten much better. So applied behavior analysis, it's a scientific method.
It has a long research base. It's not applied to just children. Actually, it's used in industries. It's used in the medical field. It might help people who don't check their blood sugar often enough. It's a tailored approach who decides what skill do you want to teach? Can you measure it? Can you observe it? How do you manipulate it? The only things we have control of are what we do before and what we do after. Ms. McIntyre, I want to jump in here. I want to open this up to
Senator Scott Flippo
Unverified
2:00:00
questions for the members. We're going to adjourn here in just about 15 minutes for lunch.
We're going to session at 1, so we have got to have some time. I appreciate your comments. Members, are we questioning? People don't understand the term. Questions for the committee.
Senator John Payton
Unverified
2:00:14
Senator Payton, you were recognized for a question. Thank you, and I don't know. I may need DHS to
answer this, but just looking at the language of the bill, I'm totally for what we're trying to accomplish. I think it's smart to take care of these people in the correct way. But it says on line 24, the first page, Arkansas Medicare program shall cover. Okay, then you jump down to the end and it says Department of Human Services shall apply for a federal waiver.
But if we're denied the waiver, are we still, I mean, if the federal Medicaid program does not cover what we're saying we're fixing to cover, are we going to be stuck with 100% of the bill instead of the 70-30 match? there we go um that is probably
Speaker 296
2:01:02
a better question for dhs i would not be able to DHS, somebody from DHS here.
Speaker 26
2:01:24
Yeah, Ms. Weatherton. Can y'all turn your mics off over there so there's a work? Okay,
Senator John Payton
Unverified
2:01:44
so yeah, there at the beginning of the bill,
in Section 1A, it says the Arkansas Medicaid program shall cover, and we describe who we want to cover, and I agree with that as long as we're getting our match.
But when we separately down here in D, we say that the DHS shall apply for the waiver. I mean,
it seems to me like the way that reads, we're covering it. Now, we're instructing DHS to apply for the waiver, but regardless of whether we get the waiver or not, we're covering it. So I'm wondering why we don't have language that says
Speaker 300
2:02:20
we're covering it if it's part of the match. Okay, good question. Melissa Weatherton, Director of Medicaid Specialty Populations. If
Speaker 302
2:02:26
you go back up to lawn on the first page, on lawn 28, where it says our participants
Speaker 303
2:02:32
in the Community and Employment Services waiver, we aren't allowed to add any services to that waiver without federal approval and y'all's
Speaker 305
2:02:38
approval, frankly. So the requirement that they be a participant would mean that there's
Senator John Payton
Unverified
2:02:43
a waiver and that there's a... Okay. Yes, sir. Yes, thanks. Melissa, do you have like a rough fiscal impact on
Speaker 135
2:02:49
this? We do. Okay. Look at that. Yes. I might bring up my
Speaker 300
2:02:57
fiscal impact expert. Okay. It's a little bit more than five.
Speaker 256
2:03:03
Five, and we have not been able to share it
Speaker 309
2:03:09
yet. Lori says it's 5.07, right? Yeah, Lori says it's here. I have it. We're out here.
Speaker 311
2:03:18
That's the range. Oh, goodness. It's not $5. Hang on.
Speaker 187
2:03:28
Pittman, Division of Medical Services. We have supplied this to
Speaker 178
2:03:33
DF&A, but have not shared it with Senator Letting it.
Speaker 314
2:03:39
I just want to make sure everybody's aware. Okay,
Speaker 302
2:03:43
great. Hold on to yourself. Okay, so we did it on kind of like a graded range. So between, you know,
Speaker 303
2:03:51
what it would cost if 250 clients, 21 and older on this waiver asked for it, up to what-if 1,584 clients, which is the number of clients on
Speaker 302
2:04:03
CES waiver with an autism diagnosis, okay? And the range is between 11.9 million to 75.9 million, which is federal share would be
At the bottom, $8.3 million. State share would be $3.6. If we serve 1584 clients, the federal share is $52.9 million and $23 million for the state. All right. Thank you. All right, members.
Speaker 316
2:04:31
Any other questions for the committee? Senator Love, you
Speaker 120
2:04:36
got a question? I guess the better question is, how many persons
Speaker 117
2:04:43
with autism are utilizing this therapy now?
Speaker 319
2:04:48
So right now we don't, Medicaid does not cover applied behavioral
analysis for anyone over the age of
Speaker 120
2:04:57
21. But is it 1,500 receiving this service right now that are under 21? Under 21? I don't have that
Speaker 302
2:05:03
under 21 numbers. Because that can give you the
Speaker 120
2:05:07
more accurate, like say for instance if only 100. Oh no, we We have
Speaker 303
2:05:12
a lot of children that get ABA. Okay. A lot. So I will tell you, on fee for service, we spend about $40 million a year on ABA for children,
and that's in addition to what we pay the passes
Speaker 320
2:05:27
to care for children with autism. We spend a lot
Speaker 303
2:05:30
of money on ABA, on Medicaid. Okay. All right. Okay. All right.
Speaker 316
2:05:39
Are there any, Senator Letting? Just one quick question to make sure I wrote it down wrong, just to clarify on
Senator Greg Leding
Unverified
2:05:45
the state's share on the range. The state's share range from 3.6 to 23 million? I'm sorry. That's okay. I
just wanted to make it. That's okay. I just wanted to make sure I wrote it down correctly.
Speaker 258
2:05:57
It's a sideshow around here, sir. That's okay. You can actually just write it down yourself. And once we get clearance, we'll send you this. Okay.
Speaker 248
2:06:10
That's what I had. Thank you. Thank you. All right. Are there any further questions from members of the committee? All
Speaker 316
2:06:16
right, say no further questions. Do we have anybody to sign up to speak for or against this bill? Don't have anybody to sign it up. Senator, you reckon that's closed.
Speaker 328
2:06:27
With the committee's permission, Mr.
Speaker 289
2:06:30
Cook would like to make a brief comment. Okay. I just
Speaker 287
2:06:37
want to emphasize the narrow target of this bill. It's right before you, and the range that's presented is, I would infer, based on my experiences, a range. I would also point out
Speaker 289
2:06:53
that this bill does have, has been received bipartisan support.
And so, I ask the committee to advance the bill for further consideration on behalf of the small group of Arkansans who will benefit in a significant way. Thank you. All right. In closing, just real quick, all I will say is,
Senator Greg Leding
Unverified
2:07:14
again, we are talking about a narrow group of Arkansans, and as Mr. Cook pointed out, while there is
a considerable investment on the front end, though, again, the state share would range from $3.6 million to $23 million, which was news to me today, there are downstream savings by the reduced visits to ER and first
responder calls. So we do believe that this is
Senator Scott Flippo
Unverified
2:07:38
an investment worth making. And I would move if now is the appropriate time to pass. All right. We've got a motion to pass by Senator Letting, a second by Senator Hill. Any discussion on the motion?
Senator John Payton
Unverified
2:07:50
Senator Payton, you're recognized for discussion. I really had a question, but I didn't
get in there in time. So it may be in discussion, since you're a committee member. Based on my decalculating of what the fiscal
impact is here, we're talking about $48,000 per person in the program, $4,000 a month. Does that sound like their own target with their estimate? Is the service we're talking about
really that much per person? I would not have that answer.
Speaker 287
2:08:26
I don't have a handle on that. This is the first that the numbers have been presented to us. What I can say is that the
Speaker 289
2:08:34
bill is written to be narrow in scope as a way to be physically
responsible. And what our argument is also is that the state taxpayers are going to recoup those costs through this preventative intervention therapy. I understand. I
Senator John Payton
Unverified
2:08:50
just wanted to check their math and if they're figuring $4,847,921 per
person. Thank you. All right. Thank you, Senator Payton. All
Senator Scott Flippo
Unverified
2:09:01
right. So we've got a motion by Senator Letting, second by Senator Hill. Seeing no
for discussion on the motion.
Waiting on Senator Penzo to get back here. All right. All in favor, say aye. Aye. Opposed? congratulations senator your bill passes all right senator penzo you want to do a house concurrent resolution on
Speaker 316
2:09:38
introduce your guest or let you both introduce yourselves for the record who you're with
Senator Clint Penzo
Unverified
2:09:44
john warmack from texer canna clint penzo senate
district 31 i'll let mr warmack speak for a few minutes one
minute or less this is a resolution house concurrent resolution 1009 it's probably the last in your stack very
Speaker 334
2:10:08
bottom this is a resolution asking the arkansas congressional delegation to introduce federal legislation to fund $10 million to Department
of Higher Education and Institution to complete Act 2, the economic study analysis in Act 259 of 2023. So it doesn't cost us anything. It brings $10 million into the state. All right, members, you've heard an explanation of the
Speaker 335
2:10:33
House Concurrent Resolution or any questions to the committee? All right. See, no questions. We have
Senator Scott Flippo
Unverified
2:10:43
anybody in the Senate to speak for or against this? Don't see anybody. Senator, you're recognized at close?
Close for the bill and ask for a good vote. All right. What's the will of the committee? Motion by Senator Love, second by Senator Penzo. Any discussion on the motion? See none. All in favor, say aye. Aye. Opposed? Congratulations. Thank you. All right, I'll tell you
Speaker 337
2:11:08
what, we are going to adjourn. What do you got?
Senator Scott Flippo
Unverified
2:11:25
We're going to recess. We're going to come back in here upon adjournment, but for the time being, we will stand in recess. Thank you.
Agenda
CALL TO ORDER
SB587 G. Leding TO CREATE THE PARENTS' PEACE OF MIND ACT; TO ESTABLISH AUTHORIZATION FOR AND USE OF A MONITORING DEVICE IN A LONG-TERM CARE FACILITY; TO PROVIDE FOR WAIVERS; AND TO PROVIDE FOR ENFORCEMENT AND PENALTIES.
SB347 C. Penzo TO REQUIRE THE ARKANSAS MEDICAID PROGRAM TO INCREASE REIMBURSEMENT RATES FOR CERTAIN DENTAL SERVICES AND TO SET AN ANNUAL REIMBURSEMENT CAP FOR ADULT DENTAL SERVICES.
SB576 B. Davis TO AMEND THE COVERAGE OF CONTINUOUS GLUCOSE MONITORS WITHIN THE ARKANSAS MEDICAID PROGRAM.
SB497 D. Wallace TO REQUIRE THE CREATION OF A POSTER REGARDING VETERANS' BENEFITS AND SERVICES; AND TO REQUIRE CERTAIN EMPLOYERS TO DISPLAY THE POSTER.
SB507 G. Leding TO REQUIRE THE ARKANSAS MEDICAID PROGRAM TO COVER APPLIED BEHAVIOR ANALYSIS SERVICES FOR CERTAIN BENEFICIARIES.
SB546 K. Hammer TO AMEND THE LAW CONCERNING THE TRUST FUND CONTRIBUTION FEE FOR WATER PERMITS RELATED TO NONMUNICIPAL DOMESTIC SEWAGE TREATMENT WORKS.
SB532 Hester TO AMEND THE DEFINITION OF "SPECIALTY HOSPITAL" RELATING TO THE ASSESSMENT FEE ON HOSPITALS UNDER THE ARKANSAS MEDICAID PROGRAM.
SB557 M. Johnson TO AMENDS LAW CONCERNING WATER PERMITS AND DISCHARGE OF WASTEWATER; TO AUTHORIZE DENIALS OF APPLICANTS THAT HAVE A HISTORY OF NONCOMPLIANCE; AND TO PROHIBIT CERTAIN DISCHARGE OF WASTEWATER.
SB312 Stone TO REMOVE THE MORATORIUM ON THE CONSTRUCTION OR ADDITION OF ANY ADDITIONAL BEDS WITHIN PSYCHIATRIC RESIDENTIAL TREATMENT FACILITIES
SB556 M. Johnson TO PROTECT PUBLIC DRINKING WATER SOURCES; AND TO PROHIBIT SURFACE DISCHARGE OF WASTEWATER INTO A WATERSHED.
SB560 J. English TO DECREASE THE BASE CONTRIBUTION RATE; TO INCREASE THE ADMINISTRATIVE ASSESSMENT RATE; TO INCREASE FUNDING FOR THE SKILLED WORKFORCE IN THIS STATE; AND TO AMEND THE DIVISION OF WORKFORCE SERVICES TRAINING TRUST FUND.
SB585 G. Leding TO REQUIRE CERTAIN RECORDS BE PROVIDED TO AN EMPLOYEE WHO IS A MINOR.
SB589 C. Penzo TO CREATE THE 340B PROGRAM TRANSPARENCY ACT; AND TO AMEND THE LAW CONCERNING TRANSPARENCY AND ACCOUNTABILITY FOR CERTAIN 340B-COVERED ENTITIES.
SB591 C. Penzo TO PROHIBIT RACE-SELECTION ABORTION IN THIS STATE; AND TO CREATE THE RACE DISCRIMINATION BY ABORTION PROHIBITION ACT.
SB474 C. Penzo TO AMEND THE LAW CONCERNING PUBLIC WATER SYSTEMS; AND TO ALLOW THE BOARD OF A PUBLIC WATER SYSTEM TO PROHIBIT FLUORIDATION OF THE WATER IN THE PUBLIC WATER SYSTEM.
SB444 K. Hammer TO AMEND THE MEDICAL ETHICS AND DIVERSITY ACT.
SB306 C. Penzo TO REQUIRE THE DEPARTMENT OF HUMAN SERVICES TO APPLY FOR A HOME- AND COMMUNITY-BASED SERVICES WAIVER FOR THE AGING AND ELDERLY POPULATION IN THIS STATE
SB311 C. Penzo TO CREATE THE END ORGAN AND GENOMIC HARVESTING ACT; TO PROHIBIT COVERAGE OF CERTAIN HUMAN ORGAN TRANSPLANT OR POST-TRANSPLANT CARE; AND TO PROHIBIT CERTAIN GENETIC SEQUENCERS AND GENETIC ANALYSIS TECHNOLOGIES.
SB2 C. Penzo TO REPEAL THE STATEWIDE FLUORIDATION PROGRAM; AND TO REMOVE THE MANDATE FOR WATER SYSTEMS TO MAINTAIN A FLUORIDE CONTENT.
SB269 C. Penzo TO AMEND THE REQUIREMENTS REGARDING LOCATIONS FOR AND GEOGRAPHIC AREAS OF A HOSPICE AGENCY.
SB262 C. Penzo TO AMEND THE CORPORATE PRACTICE OF MEDICINE DOCTRINE; AND TO AUTHORIZE A LICENSED MEDICAL PROFESSIONAL WHO OWNS A MEDICAL CORPORATION TO MAINTAIN OWNERSHIP UPON AN INACTIVE LICENSE OR RETIREMENT.
SB255 C. Penzo TO AMEND THE DEFINITION OF "DRUG" WITHIN THE FOOD, DRUG, AND COSMETIC ACT; AND TO DECLARE AN EMERGENCY.
SB225 J. Scott TO REQUIRE THE ARKANSAS MEDICAID PROGRAM TO PROVIDE A CATEGORY FOR BENEFICIARIES WITH SICKLE CELL DISEASE.
SB217 C. Penzo TO REQUIRE THE DEPARTMENT OF HUMAN SERVICES TO REQUEST A WAIVER TO EXCLUDE CANDY AND SOFT DRINKS FROM ELIGIBLE FOODS UNDER THE SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM.
SB122 C. Penzo TO AMEND THE AUTOMATIC OCCUPATIONAL LICENSURE FOR OUT-OF-STATE LICENSURE ACT; TO APPLY THE AUTOMATIC OCCUPATIONAL LICENSURE FOR OUT-OF-STATE LICENSURE ACT TO PHYSICIANS.
SB121 C. Penzo TO AMEND THE AUTOMATIC OCCUPATIONAL LICENSURE FOR OUT-OF-STATE LICENSURE ACT; TO APPLY THE AUTOMATIC OCCUPATIONAL LICENSURE FOR OUT-OF-STATE LICENSURE ACT TO PHYSICIAN ASSISTANTS.
SB95 C. Penzo TO AMEND THE ARKANSAS ATHLETIC TRAINERS ACT; AND TO CLARIFY THE DEFINITION OF "ATHLETE" WITHIN THE ARKANSAS ATHLETIC TRAINERS ACT.
SB110 C. Penzo TO AUTHORIZE CERTIFIED NURSE AIDES OR CERTIFIED NURSING ASSISTANTS WHO PROVIDE IN-HOME SERVICES TO BENEFICIARIES IN THE ARKANSAS MEDICAID PROGRAM TO PERFORM ADDITIONAL CARE AND DUTIES.
SB601 Hester TO CREATE A PATHWAY FOR A GRADUATE OF A FOREIGN MEDICAL SCHOOL TO BE LICENSED IN THIS STATE IF HE OR SHE IS OFFERED FULL-TIME EMPLOYMENT AS A PHYSICIAN FROM A HEALTHCARE PROVIDER.
SB603 C. Tucker TO REQUIRE AN AIR AMBULANCE TO CONTACT THE ARKANSAS TRAUMA SYSTEM FOR DIRECTION ON THE BEST DESTINATION TO TRANSPORT A PERSON.
SB606 B. Davis TO AMEND THE USED TIRE RECYCLING AND ACCOUNTABILITY ACT; TO CREATE THE TIRE MANAGEMENT AND RECYCLING ACT; TO REPEAL THE USED TIRE RECYCLING FUND; AND TO CREATE THE WASTE TIRE ABATEMENT FUND.
HB1186 Vaught TO CREATE THE PAIN RELIEF PARITY ACT; AND TO REQUIRE PAIN RELIEF PARITY IN THE ARKANSAS MEDICAID PROGRAM.
HB1131 Pilkington TO AUTHORIZE AN ADVANCED PRACTICE REGISTERED NURSE TO DELEGATE CERTAIN TASKS TO MEDICAL ASSISTANTS AND OTHER UNLICENSED STAFF.
HB1171 K. Moore TO MODIFY THE MEDICAID PROVIDER-LED ORGANIZED CARE ACT; AND TO AUTHORIZE AN ABBREVIATED INDEPENDENT ASSESSMENT FOR CERTAIN BENEFICIARIES ENROLLED IN A RISK-BASED PROVIDER ORGANIZATION.
HB1403 Pilkington TO AMEND THE ARKANSAS HEALTH AND OPPORTUNITY FOR ME ACT OF 2021 TO ALLOW NONHOSPITAL ENTITIES TO BE COMMUNITY BRIDGE ORGANIZATIONS.
HB1439 Ladyman TO REMOVE THE CERTIFICATION PROCESS OF THE DEPARTMENT OF HUMAN SERVICES FROM LICENSURE AS A PRIVATE CARE AGENCY.
HB1440 Bentley TO AMEND THE MASSAGE THERAPY ACT; AND TO ESTABLISH REGISTRATION FOR MASSAGE THERAPY ESTABLISHMENTS.
HB1454 Bentley TO AMEND THE LAWS CONCERNING CRIMINAL HISTORY RECORDS CHECKS FOR EMPLOYEES OF SERVICE PROVIDERS; TO ALLOW THIRD-PARTY EMPLOYEE EVALUATION SERVICES TO PERFORM CRIMINAL HISTORY RECORDS CHECKS; AND TO INCLUDE INDEPENDENT CONTRACTORS.
HB1456 Rose TO AMEND THE STATE KIDNEY DISEASE COMMISSION TO BE AN ADVISORY COUNCIL TO THE DEPARTMENT OF HEALTH.
HB1251 L. Johnson TO ESTABLISH THE ARKANSAS ANESTHESIOLOGIST ASSISTANT ACT; AND TO PROVIDE FOR LICENSURE OF ANESTHESIOLOGIST ASSISTANTS.
HB1458 L. Johnson TO AMEND THE DEFINITION OF "CREDENTIALING INFORMATION" WHEN THE ARKANSAS STATE MEDICAL BOARD IS PROVIDING INFORMATION TO CREDENTIALING ORGANIZATIONS.
HB1537 Ladyman TO REPEAL THE LOCATION ACT FOR COMMUNITY HOMES FOR INDIVIDUALS WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES.
HB1428 Steimel TO AMEND THE LAW REGARDING PUBLIC LODGING; AND TO PROVIDE A BED HEIGHT REQUIREMENT FOR MOBILITY ACCESSIBLE ROOMS.
HB1523 Vaught CONCERNING MISSING PERSONS ALERTS; TO CODIFY THE ARKANSAS AMBER ALERT SYSTEM; TO CODIFY THE ARKANSAS SILVER ALERT SYSTEM; AND TO CREATE THE ARKANSAS PURPLE ALERT SYSTEM.
HB1442 Achor TO SET RESTRICTIONS ON PHARMACY CONTRACTING AND CONFLICTS OF INTEREST; AND TO ESTABLISH PHARMACEUTICAL PATIENT FREEDOM OF CHOICE.
HB1471 Wooldridge TO AMEND THE EXPIRATION DATE OF ALL LICENSES OF THE BOARD OF EXAMINERS IN SPEECH-LANGUAGE PATHOLOGY AND AUDIOLOGY.
HB1185 L. Johnson TO ADOPT THE DIETITIAN LICENSURE COMPACT IN ARKANSAS.
HB1559 McGrew TO REQUIRE THE DEPARTMENT OF HUMAN SERVICES TO SEEK A WAIVER TO THE ARKANSAS MEDICAID PROGRAM FOR COVERAGE FOR INPATIENT TREATMENT SERVICES FOR SUBSTANCE USE DISORDERS.
HB1429 M. Shepherd TO INCREASE ACCESSIBILITY WHILE ENSURING QUALITY FOR CERTAIN FACILITIES PERFORMING MAMMOGRAPHY SERVICES; AND TO AMEND THE LAW CONCERNING THE QUALITY STANDARDS FOR ACCREDITATION OF FACILITIES FOR MAMMOGRAPHY.
HB1285 L. Johnson TO ESTABLISH AN EXEMPTION PROGRAM FOR AMBULANCE SERVICE'S OPERATORS FOR CERTAIN HEALTHCARE SERVICES.
HB1576 Lundstrum TO PROHIBIT A SOLID WASTE LANDFILL TO BE PLACED OVER A KARST TOPOGRAPHY.
HB1218 J. Mayberry TO CREATE LICENSURE FOR THERAPEUTIC RECREATION SPECIALISTS; AND TO CREATE THE THERAPEUTIC RECREATION PRACTICE ACT.
HB1682 Puryear TO CREATE THE GOOD NEIGHBOR ACT; AND TO CLARIFY FOOD DONATION LIABILITY AND IMMUNITY.
HB1252 L. Johnson TO ESTABLISH THE CERTIFIED COMMUNITY-BASED DOULA CERTIFICATION ACT; AND TO CERTIFY BIRTH AND POSTPARTUM DOULAS IN THIS STATE TO IMPROVE MATERNAL AND INFANT OUTCOMES.
HB1585 L. Johnson TO PROVIDE AN EXCEPTION FROM LICENSURE AS A HOME HEALTHCARE SERVICE TO AN ENTITY THAT SOLELY PROVIDES THERAPY SERVICES THAT ARE NOT REIMBURSED BY MEDICARE PART A.
HB1712 Joey Carr TO ESTABLISH THE SOCIAL WORK LICENSURE COMPACT IN THIS STATE.
HB1582 McAlindon TO REQUIRE CERTAIN ACTIONS AND ENCOURAGE CERTAIN ACTIONS FOR AN INDIVIDUAL TO BE ELIGIBLE FOR BENEFITS UNDER THE DIVISION OF WORKFORCE SERVICES LAW.
HB1622 Gramlich TO AMEND THE MEDICAID FAIRNESS ACT; TO MODIFY THE DEFINITION OF "ADVERSE DECISION" UNDER THE MEDICAID FAIRNESS ACT; AND TO PROVIDE FOR ADMINISTRATIVE RECONSIDERATION UNDER THE MEDICAID FAIRNESS ACT.
HB1619 Gramlich TO SET ADMINISTRATION FEES UNDER THE ARKANSAS MEDICAID PROGRAM FOR IMMUNIZATIONS AND MONOCLONAL ANTIBODIES FOR RESPIRATORY SYNCYTIAL VIRUS DISEASE; AND TO PROVIDE CIVIL IMMUNITY.
HB1734 Childress TO AMEND THE LAW CONCERNING DEATH CERTIFICATES; AND TO CLARIFY THE MEDICAL PROFESSIONALS WHO MAY SIGN A MEDICAL CERTIFICATE OF DEATH AND PRONOUNCE DEATH OF A PATIENT.
HB1758 Gramlich TO AMEND THE LAW CONCERNING HEARING INSTRUMENT DISPENSERS; AND TO AMEND THE DEFINITION OF "PRACTICE OF DISPENSING HEARING INSTRUMENTS".
HB1255 Wooldridge TO AMEND THE COVERAGE OF A CONTINUOUS GLUCOSE MONITOR IN THE ARKANSAS MEDICAID PROGRAM.
HB1241 J. Mayberry TO ENSURE THAT THE ARKANSAS MEDICAID PROGRAM REIMBURSES FOR DENTAL AND ANESTHESIA COSTS FOR HIGH COMPLEXITY ORAL HEALTH CARE.
HB1679 M. Brown TO AMEND THE REVISED ARKANSAS ANATOMICAL GIFT ACT; TO ALLOW CERTAIN CLASSES OF PERSONS TO REVOKE OR AMEND AN ANATOMICAL GIFT UPON THE DEATH OF THE DONOR; AND TO REQUIRE CERTAIN REPORTING OF PROCUREMENT ORGANIZATIONS.
HB1782 Hudson TO PROHIBIT OVER-THE-COUNTER DIET PILLS FROM BEING SOLD, TRANSFERRED, OR OTHERWISE FURNISHED TO A PERSON WHO IS UNDER EIGHTEEN YEARS OF AGE.
HB1543 Underwood TO ESTABLISH THE WORKFORCE EXPERIENCE OPPORTUNITIES ACT OF 2025.
HB1767 L. Johnson TO ABOLISH THE EMERGENCY MEDICAL SERVICES ADVISORY COUNCIL; AND TO CREATE THE EMERGENCY MEDICAL SERVICES ADVISORY COMMITTEE.
HB1801 K. Moore TO AUTHORIZE AN OUTSOURCING FACILITY OF LEGEND DRUGS AND CONTROLLED SUBSTANCES THAT COMPOUNDS A PRODUCT TO SELL THE COMPOUNDED PRODUCT TO CERTAIN ENTITIES.
HB1817 L. Johnson TO ESTABLISH ELIJAH'S LAW IN ARKANSAS; AND TO REQUIRE THE DEPARTMENT OF HEALTH AND THE DEPARTMENT OF EDUCATION TO ESTABLISH A STATEWIDE ANAPHYLAXIS POLICY FOR CHILDCARE FACILITIES.
HB1840 L. Johnson TO AMEND THE MEDICAID PROVIDER-LED ORGANIZED CARE ACT TO ENSURE THAT SEDATION DENTISTRY IS COVERED BY RISK-BASED PROVIDER ORGANIZATIONS.
HB1841 L. Johnson TO CREATE THE ARKANSAS REVENUE INVESTMENT IN VITAL EMS SYSTEMS (ARRIVES) ACT; AND TO CREATE THE ARKANSAS REVENUE INVESTMENT IN VITAL EMS SYSTEMS (ARRIVES) FUND FOR EMERGENCY MEDICAL SERVICES AGENCIES.
HB1004 Pilkington TO REQUIRE MEDICAID COVERAGE FOR POSTPARTUM MOTHERS FOR ONE YEAR AFTER GIVING BIRTH.
HB1187 Vaught TO AUTHORIZE A LICENSURE BY ENDORSEMENT FOR MARRIAGE AND FAMILY THERAPISTS.
HB1677 Bentley TO AUTHORIZE ALCOHOL AND DRUG ABUSE TREATMENT PROGRAMS TO MAINTAIN EMERGENCY MEDICATION KITS.
HB1751 Underwood TO REQUIRE AN APPLICANT FOR TEMPORARY ASSISTANCE FOR NEEDY FAMILIES PROGRAM BENEFITS TO ENGAGE IN JOB SEARCH ACTIVITIES WHILE THE APPLICATION IS BEING PROCESSED.
HB1784 Wardlaw TO MODIFY THE INFORMAL DISPUTE RESOLUTION PROCESS FOR LONG-TERM CARE FACILITIES.
HCR1009 Ladyman TO COMPLY WITH ARKANSAS ACTS 2023, NO. 259; TO REQUEST FEDERAL FUNDING FOR THE NEXT STUDY PHASE; AND TO PETITION THE ARKANSAS CONGRESSIONAL DELEGATION TO INTRODUCE FEDERAL LEGISLATION TO RECTIFY CERTAIN ENERGY ISSUES.
SERVICES; AND TO AMEND THE DEFINITION OF "EMPLOYEE" UNDER THE WORKERS' COMPENSATION LAW RESULTING FROM INITIATED ACT 4 OF 1948.
ADJOURNED
Documents
| Title | Type | Pages | Source |
|---|---|---|---|
| Agenda — PUBLIC HEALTH WELFARE AND LABOR COMMITTEE - SENATE AND HOUSE, Apr 2, 2025 | Agenda | 5 | Official source ↗ |
Speakers
Senator Dave Wallace
Unverified
Senator Breanne Davis
Unverified
Speaker 27
Speaker 29
Speaker 32
Senator Fredrick J. Love
Unverified
Senator John Payton
Unverified
Speaker 40
Senator Kim Hammer
Unverified
Speaker 54
Speaker 58
Speaker 69
Speaker 71
Senator Missy Irvin
Unverified
Speaker 79
Senator Clint Penzo
Unverified
Speaker 99
Speaker 101
Speaker 103
Speaker 113
Speaker 114
Speaker 102
Speaker 118
Senator Jane English
Unverified
Speaker 142
Speaker 61
Speaker 153
Speaker 155
Speaker 157
Speaker 161
Speaker 163
Speaker 174
Speaker 144
Speaker 178
Speaker 164
Speaker 183
Speaker 187
Speaker 166
Speaker 196
Speaker 198
Speaker 47
Senator Greg Leding
Unverified
Speaker 216
Rhonda Finley
Unverified
Speaker 219
Speaker 220
Deborah Stewart
Unverified
Speaker 120
Chair
Unverified
Speaker 188
Speaker 239
Speaker 242
Speaker 244
Speaker 149
Senator Scott Flippo
Unverified
Rachel Bunch
Unverified
Speaker 222
Speaker 260
Speaker 271
Speaker 276
Speaker 140
Speaker 74
Ron Cook
Unverified
Speaker 286
Speaker 289
Speaker 290
Speaker 291
Speaker 288
Speaker 296
Speaker 26
Speaker 300
Speaker 302
Speaker 303
Speaker 305
Speaker 135
Speaker 256
Speaker 309
Speaker 311
Speaker 246
Speaker 314
Speaker 316
Speaker 117
Speaker 319
Speaker 320
Speaker 258
Speaker 248
Speaker 328
Speaker 287
Speaker 332
Speaker 334
Speaker 335
Speaker 337