Public Health, Welfare and Labor Committee- House
Video
Transcript
1 document
Bills discussed (51)
| Bill | Title | Sponsor | Status |
|---|---|---|---|
|
SB101
Act 300
· 4 mentions in agenda, transcript, chapter
Matched: “…AUTHORIZE A PHYSICIAN ASSISTANT TO DELEGATE CERTAIN TASKS. SB101 C. Penzo TO ESTABLISH THE PHYSICIAN ASSISTANT LICENSURE COM…”
|
TO ESTABLISH THE PHYSICIAN ASSISTANT LICENSURE COMPACT. | C. Penzo | Notification that SB101 is now Act 300 |
|
SB99
Act 437
· 4 mentions in chapter, transcript
Matched: “SB99 C. Penzo TO AUTHORIZE A PHYSICIAN ASSISTANT TO DELEGATE CER…”
|
TO AUTHORIZE A PHYSICIAN ASSISTANT TO DELEGATE CERTAIN TASKS. | C. Penzo | Notification that SB99 is now Act 437 |
|
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. |
|
HB1079
Act 860
· 2 mentions in chapter, agenda
Matched: “HB1079 F. Allen TO MANDATE COVERAGE FOR GENETIC TESTING FOR AN INH…”
|
TO MANDATE COVERAGE FOR GENETIC TESTING FOR AN INHERITED GENE MUTATION FOR CERTAIN INDIVIDUALS; AND … | F. Allen | Notification that HB1079 is now Act 860 |
|
HB1131
Act 959
· 2 mentions in transcript
Matched: “…actitioners did pass a similar bill through this committee, HB 1131, which allows them to delegate tasks to unlicensed uh profe…”
|
TO AUTHORIZE AN ADVANCED PRACTICE REGISTERED NURSE TO DELEGATE CERTAIN TASKS TO MEDICAL ASSISTANTS AND … | Pilkington | Notification that HB1131 is now Act 959 |
|
HB1164
· 2 mentions in agenda, chapter
Matched: “…FOR EVIDENCE-BASED CANCER IMAGING FOR CERTAIN INDIVIDUALS. HB1164 J. Mayberry TO ALLOW A PHYSICIAN OR HEALTHCARE PROVIDER TO…”
|
TO ALLOW A PHYSICIAN OR HEALTHCARE PROVIDER TO OFFER COGNITIVE ASSESSMENTS FOR CERTAIN PATIENTS; AND … | J. Mayberry | Died in Senate Committee at Sine Die adjournment. |
|
HB1218
· 2 mentions in agenda, chapter
Matched: “…BLIC SAFETY EMPLOYEE WHO HAS EXPERIENCED A TRAUMATIC EVENT. 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 chapter, transcript
Matched: “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 |
|
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 |
|
HB1275
Act 389
· 2 mentions in chapter, agenda
Matched: “HB1275 Cavenaugh TO PROHIBIT PRIOR AUTHORIZATIONS FOR HEALTHCARE S…”
|
TO PROHIBIT PRIOR AUTHORIZATIONS FOR HEALTHCARE SERVICES PROVIDED FOR TREATMENT OF A MENTAL HEALTH CRISIS. | Cavenaugh | Notification that HB1275 is now Act 389 |
|
HB1468
Act 558
· 2 mentions in chapter, agenda
Matched: “HB1468 Cozart TO AMEND ARKANSAS LAW CONCERNING CLAIMS AGAINST CONT…”
|
TO AMEND ARKANSAS LAW CONCERNING CLAIMS AGAINST HOME IMPROVEMENT CONTRACTORS, RESIDENTIAL BUILDING CONTRACTORS, AND SUPPLIERS. | Cozart | Notification that HB1468 is now Act 558 |
|
HB1505
Act 398
· 2 mentions in agenda, chapter
Matched: “…ORY SYNCYTIAL VIRUS DISEASE; AND TO PROVIDE CIVIL IMMUNITY. HB1505 Wing TO REQUIRE A PUBLIC EMPLOYER TO OFFER AND PROVIDE COVE…”
|
TO REQUIRE A PUBLIC EMPLOYER TO OFFER AND PROVIDE COVERAGE FOR LICENSED COUNSELING FOR A … | Wing | Notification that HB1505 is now Act 398 |
|
HB1530
· 2 mentions in chapter, agenda
Matched: “HB1530 Achor TO AMEND THE DEFINITION OF "SPECIALTY HOSPITAL" RELAT…”
|
TO AMEND THE DEFINITION OF "SPECIALTY HOSPITAL" RELATING TO THE ASSESSMENT FEE ON HOSPITALS UNDER … | Achor | Died in House Committee at Sine Die adjournment. |
|
HB1543
Act 631
· 2 mentions in chapter, agenda
Matched: “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 |
|
HB1582
Act 708
· 2 mentions in agenda, chapter
Matched: “…TABLISH THE WORKFORCE EXPERIENCE OPPORTUNITIES ACT OF 2025. HB1582 McAlindon TO REQUIRE AN INDIVIDUAL TO TAKE CERTAIN ACTIONS…”
|
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 chapter, agenda
Matched: “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 |
|
HB1592
· 2 mentions in chapter, agenda
Matched: “HB1592 J. Mayberry TO CREATE THE ARKANSAS ALZHEIMER'S AND DEMENTIA…”
|
TO CREATE THE ARKANSAS ALZHEIMER'S AND DEMENTIA PUBLIC HEALTH ACT. | J. Mayberry | Died in House Committee at Sine Die adjournment. |
|
HB1619
Act 634
· 2 mentions in chapter, agenda
Matched: “HB1619 Gramlich TO SET ADMINISTRATION FEES UNDER THE ARKANSAS MEDI…”
|
TO SET ADMINISTRATION FEES UNDER THE ARKANSAS MEDICAID PROGRAM FOR IMMUNIZATIONS AND MONOCLONAL ANTIBODIES FOR … | Gramlich | Notification that HB1619 is now Act 634 |
|
HB1622
Act 635
· 2 mentions in agenda, chapter
Matched: “…COMPREHENSIVE INFORMATION IN NOTICES OF ADVERSE DECISIONS. 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 |
|
HB1653
Act 636
· 2 mentions in agenda, chapter
Matched: “…ON OF "AUDIOLOGY" RELATING TO THE PRACTICE OF AUDIOLOGISTS. HB1653 Cavenaugh TO SET STANDARDS FOR THE LICENSING AND REGULATION…”
|
TO SET STANDARDS FOR LICENSING AND REGULATION OF PSYCHIATRIC RESIDENTIAL TREATMENT FACILITIES; AND TO DECLARE … | Cavenaugh | Notification that HB1653 is now Act 636 |
|
HB1679
Act 861
· 2 mentions in agenda, chapter
Matched: “…estrictions designating areas as 'Members and Staff Only'. HB1679 M. Brown TO AMEND THE REVISED ARKANSAS ANATOMICAL GIFT ACT;…”
|
TO AMEND THE REVISED ARKANSAS ANATOMICAL GIFT ACT; TO ALLOW CERTAIN CLASSES OF PERSONS TO … | M. Brown | Notification that HB1679 is now Act 861 |
|
HB1682
Act 942
· 2 mentions in chapter, agenda
Matched: “HB1682 Puryear TO CREATE THE GOOD NEIGHBOR ACT; AND TO CLARIFY FOO…”
|
TO CREATE THE GOOD NEIGHBOR ACT; AND TO CLARIFY FOOD DONATION LIABILITY AND IMMUNITY. | Puryear | Notification that HB1682 is now Act 942 |
|
SB100
Act 482
· 2 mentions in agenda, chapter
Matched: “…TO REQUIRE CERTAIN REPORTING OF PROCUREMENT ORGANIZATIONS. SB100 C. Penzo TO AUTHORIZE THE ARKANSAS MEDICAID PROGRAM TO RECO…”
|
TO AUTHORIZE THE ARKANSAS MEDICAID PROGRAM TO RECOGNIZE A PHYSICIAN ASSISTANT AS A PRIMARY CARE … | C. Penzo | Notification that SB100 is now Act 482 |
|
SB189
Act 396
· 2 mentions in agenda, chapter
Matched: “…R ACT; AND TO CLARIFY FOOD DONATION LIABILITY AND IMMUNITY. SB189 A. Clark TO AUTHORIZE IVERMECTIN FOR HUMAN USE TO BE SOLD W…”
|
TO AUTHORIZE IVERMECTIN FOR HUMAN USE TO BE SOLD WITHOUT A PRESCRIPTION OR CONSULTATION WITH … | A. Clark | Notification that SB189 is now Act 396 |
|
HB1008
· 1 mention in agenda
Matched: “…NG ACT. Page 2 of 4 DEFERRED BILLS Number Sponsor Subtitle HB1008 A. Collins TO REQUIRE MEDICAID COVERAGE FOR POSTPARTUM MOTH…”
|
TO REQUIRE MEDICAID COVERAGE FOR POSTPARTUM MOTHERS FOR ONE YEAR AFTER GIVING BIRTH. | A. Collins | Died in House Committee at Sine Die adjournment. |
|
HB1010
· 1 mention in agenda
Matched: “…AGE FOR POSTPARTUM MOTHERS FOR ONE YEAR AFTER GIVING BIRTH. HB1010 A. Collins TO SET THE REIMBURSEMENT RATE IN THE ARKANSAS ME…”
|
TO SET THE REIMBURSEMENT RATE IN THE ARKANSAS MEDICAID PROGRAM FOR MATERNAL HEALTH SERVICES. | A. Collins | Died in House Committee at Sine Die adjournment. |
|
HB1011
· 1 mention in agenda
Matched: “…THE ARKANSAS MEDICAID PROGRAM FOR MATERNAL HEALTH SERVICES. HB1011 A. Collins TO CREATE THE RESTORE ROE ACT; AND TO RESTORE A…”
|
TO CREATE THE RESTORE ROE ACT; AND TO RESTORE A WOMAN'S ACCESS TO ABORTION SERVICES. | A. Collins | Died in House Committee at Sine Die adjournment. |
|
HB1012
· 1 mention in agenda
Matched: “…ACT; AND TO RESTORE A WOMAN'S ACCESS TO ABORTION SERVICES. HB1012 A. Collins TO REQUIRE THE ARKANSAS MEDICAID PROGRAM TO EXTE…”
|
TO REQUIRE THE ARKANSAS MEDICAID PROGRAM TO EXTEND ELIGIBILITY TO CERTAIN INDIVIDUALS FOR FAMILY PLANNING … | A. Collins | Died in House Committee at Sine Die adjournment. |
|
HB1013
· 1 mention in agenda
Matched: “…BILITY TO CERTAIN INDIVIDUALS FOR FAMILY PLANNING SERVICES. HB1013 Hudson TO PROTECT FERTILITY TREATMENT RIGHTS IN THIS STATE.…”
|
TO PROTECT FERTILITY TREATMENT RIGHTS IN THIS STATE. | Hudson | Died in House Committee at Sine Die adjournment. |
|
HB1029
· 1 mention in agenda
Matched: “…Hudson TO PROTECT FERTILITY TREATMENT RIGHTS IN THIS STATE. HB1029 D. Garner TO SET THE REIMBURSEMENT RATE IN THE ARKANSAS MED…”
|
TO SET THE REIMBURSEMENT RATE IN THE ARKANSAS MEDICAID PROGRAM FOR MENTAL HEALTH SERVICES AND … | D. Garner | Died in House Committee at Sine Die adjournment. |
|
HB1032
· 1 mention in agenda
Matched: “…R MENTAL HEALTH SERVICES AND SERVICES RELATED TO ADDICTION. HB1032 A. Collins TO BAN CONVERSION THERAPY. HB1132 Pilkington TO…”
|
TO BAN CONVERSION THERAPY. | A. Collins | Died in House Committee at Sine Die adjournment. |
|
HB1132
· 1 mention in agenda
Matched: “…TO ADDICTION. HB1032 A. Collins TO BAN CONVERSION THERAPY. HB1132 Pilkington TO INCREASE ACCESS TO HEALTHCARE SERVICES PROVID…”
|
TO INCREASE ACCESS TO HEALTHCARE SERVICES PROVIDED BY ADVANCED PRACTICE REGISTERED NURSES; AND TO AMEND … | Pilkington | Died in House Committee at Sine Die adjournment. |
|
HB1140
· 1 mention in agenda
Matched: “…RIPTIVE AUTHORITY OF AN ADVANCED PRACTICE REGISTERED NURSE. HB1140 Gramlich TO DEFINE HEALTHCARE PROVIDER REGARDING STUDENT AT…”
|
TO DEFINE HEALTHCARE PROVIDER REGARDING STUDENT ATHLETE CONCUSSION EDUCATION. | Gramlich | WITHDRAWN BY AUTHOR |
|
HB1142
Act 859
· 1 mention in agenda
Matched: “…ANT OUTCOMES. PENDING FISCAL IMPACT Number Sponsor Subtitle HB1142 A. Brown TO CREATE THE REPRODUCTIVE EMPOWERMENT AND SUPPORT…”
|
TO CREATE THE REPRODUCTIVE EMPOWERMENT AND SUPPORT THROUGH OPTIMAL RESTORATION (RESTORE) ACT. | A. Brown | Notification that HB1142 is now Act 859 |
|
HB1165
· 1 mention in agenda
Matched: “…RE PROVIDER REGARDING STUDENT ATHLETE CONCUSSION EDUCATION. HB1165 L. Johnson TO PROHIBIT DIFFERENT REIMBURSEMENT RATES FOR SE…”
|
TO PROHIBIT DIFFERENT REIMBURSEMENT RATES FOR SERVICES PERFORMED BY THE SAME TYPE OF PROVIDER IN … | L. Johnson | WITHDRAWN BY AUTHOR |
|
HB1224
· 1 mention in agenda
Matched: “…IN DIFFERENT SETTINGS WITHIN THE ARKANSAS MEDICAID PROGRAM. HB1224 Nazarenko TO AMEND THE AUTOMATIC OCCUPATIONAL LICENSURE FOR…”
|
TO AMEND THE AUTOMATIC OCCUPATIONAL LICENSURE FOR OUT-OF-STATE LICENSURE ACT; AND TO APPLY THE AUTOMATIC … | Nazarenko | Died in House Committee at Sine Die adjournment. |
|
HB1244
· 1 mention in agenda
Matched: “…NSURE FOR OUT-OF-STATE LICENSURE ACT TO MASSAGE THERAPISTS. HB1244 K. Brown TO AMEND THE REQUIREMENTS TO OBTAIN A CERTIFICATE…”
|
TO AMEND THE REQUIREMENTS TO OBTAIN A CERTIFICATE OF FULL INDEPENDENT PRACTICE AUTHORITY BY A … | K. Brown | Died in House Committee at Sine Die adjournment. |
|
HB1270
· 1 mention in agenda
Matched: “…CERTIFIED NURSE PRACTITIONER OR CLINICAL NURSE SPECIALIST. HB1270 Pilkington TO ESTABLISH LICENSURE FOR PRESCRIBED PEDIATRIC…”
|
TO ESTABLISH A PRESCRIBED PEDIATRIC EXTENDED CARE PILOT PROGRAM THROUGH A SECTION 1115 MEDICAID DEMONSTRATION … | Pilkington | Died in House Committee at Sine Die adjournment. |
|
HB1277
Act 706
· 1 mention in agenda
Matched: “…AM TO REIMBURSE PRESCRIBED PEDIATRIC EXTENDED CARE CENTERS. HB1277 Gramlich TO AMEND PAYMENTS FOR CORRECTIVE ACTION REGARDING…”
|
TO AMEND PAYMENTS FOR CORRECTIVE ACTION REGARDING PETROLEUM STORAGE TANKS. | J. Boyd | Notification that HB1277 is now Act 706 |
|
HB1302
· 1 mention in agenda
Matched: “…/10/25 @ 11:08 AM) Moved HB1252 to Regular Agenda and Moved HB1302 to Deferred Bills House Committee on Public Health, Welfare…”
|
TO ADD DUCHENNE MUSCULAR DYSTROPHY TO THE UNIVERSAL NEWBORN SCREENING ACT. | L. Johnson | WITHDRAWN BY AUTHOR |
|
HB1506
· 1 mention in agenda
Matched: “…PSYCHOLOGICAL OR PSYCHOLOGICAL TEST MATERIALS OR TEST DATA. HB1506 Andrews TO AMEND THE LAW CONCERNING PUBLIC OFFICERS AND EMP…”
|
TO AMEND THE LAW CONCERNING PUBLIC OFFICERS AND EMPLOYEES; AND TO PROHIBIT A PUBLIC EMPLOYER … | Andrews | WITHDRAWN BY AUTHOR |
|
HB1532
· 1 mention in agenda
Matched: “…MEMBERSHIP DUES FROM THE COMPENSATION OF A PUBLIC EMPLOYEE. HB1532 L. Johnson TO CREATE THE ARKANSAS RARE DISEASE ADVISORY COU…”
|
TO CREATE THE ARKANSAS RARE DISEASE ADVISORY COUNCIL. | L. Johnson | WITHDRAWN BY AUTHOR |
|
HB1554
· 1 mention in agenda
Matched: “…O KNOWN AS GLP-1 AGONISTS, WHEN PRESCRIBED FOR WEIGHT LOSS. HB1554 A. Brown TO CREATE THE ASSISTED REPRODUCTIVE TECHNOLOGY REP…”
|
TO CREATE THE ASSISTED REPRODUCTIVE TECHNOLOGY REPORTING ACT. | A. Brown | Recommended for study in the Interim by the … |
|
HB1566
· 1 mention in agenda
Matched: “…hnson TO CREATE THE ARKANSAS RARE DISEASE ADVISORY COUNCIL. HB1566 McClure TO REQUIRE ADOPTION OF A STATEWIDE PRACTICAL NURSIN…”
|
TO REQUIRE ADOPTION OF A STATEWIDE PRACTICAL NURSING PROGRAM CORE CURRICULUM TO INCREASE CONSISTENCY IN … | McClure | Died in House Committee at Sine Die adjournment. |
|
HB1584
· 1 mention in agenda
Matched: “…SE CONSISTENCY IN PRACTICAL NURSING EDUCATION. Page 3 of 4 HB1584 L. Johnson TO REQUIRE INDEPENDENT ASSESSMENTS OF A BENEFICI…”
|
TO REQUIRE INDEPENDENT ASSESSMENTS OF A BENEFICIARY IN THE ARKANSAS MEDICAID PROGRAM FOR HOME- AND … | L. Johnson | WITHDRAWN BY AUTHOR |
|
HB1588
· 1 mention in agenda
Matched: “…OMMUNITY-BASED SERVICES BE COMPLETED WITHIN A CERTAIN TIME. HB1588 McAlindon TO REQUIRE APPROVAL OF THE GENERAL ASSEMBLY BEFOR…”
|
TO REQUIRE APPROVAL OF THE GENERAL ASSEMBLY BEFORE THE DEPARTMENT OF HUMAN SERVICES SEEKS OR … | McAlindon | Died in House Committee at Sine Die adjournment. |
|
SB111
Act 395
· 1 mention in chapter
Matched: “SB111 K. Hammer TO ESTABLISH THE DENTIST AND DENTAL HYGIENIST COM…”
|
TO ESTABLISH THE DENTIST AND DENTAL HYGIENIST COMPACT. | K. Hammer | Notification that SB111 is now Act 395 |
|
SB118
Act 517
· 1 mention in chapter
Matched: “SB118 C. Penzo TO AMEND THE DEFINITION OF "AUDIOLOGY" RELATING TO…”
|
TO AMEND THE DEFINITION OF "AUDIOLOGY" RELATING TO THE PRACTICE OF AUDIOLOGISTS. | C. Penzo | Notification that SB118 is now Act 517 |
|
SB168
· 1 mention in agenda
Matched: “…G UTILIZATION REVIEW BOARD TO INCLUDE PHYSICIAN ASSISTANTS. SB168 Rice TO ESTABLISH A STATE EXAMINATION FOR LICENSURE OF MASS…”
|
TO ESTABLISH A STATE EXAMINATION FOR LICENSURE OF MASSAGE THERAPISTS. | Rice | Died on House Calendar at Sine Die adjournment. |
|
SB187
· 1 mention in agenda
Matched: “…EASES COSTS TO THE STATE FOR THE ARKANSAS MEDICAID PROGRAM. SB187 Irvin TO AMEND THE COMPOSITION OF THE ARKANSAS MEDICAID DRU…”
|
TO AMEND THE COMPOSITION OF THE ARKANSAS MEDICAID DRUG UTILIZATION REVIEW BOARD TO INCLUDE PHYSICIAN … | Irvin | Died in House Committee at Sine Die adjournment. |
|
SB257
Act 515
· 1 mention in chapter
Matched: “SB257 C. Penzo TO AMEND THE MEDICAID FAIRNESS ACT; TO EXTEND THE…”
|
TO AMEND THE MEDICAID FAIRNESS ACT; TO EXTEND THE APPEAL PERIOD FOR PROVIDERS IN THE … | C. Penzo | Notification that SB257 is now Act 515 |
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take a little bit of a flexible schedule and try to accommodate some of our members. Representative Graham, like, are you prepared to present Senate Bill 99? Yes, sir, and I'm going to ask someone to meet me at the table. Please come to the end of the table and identify yourself for
Speaker 4
0:29
the record and any organization that you may represent. Hi, my name's Aaron Woodall. I'm a family practice PA and I'm representing the Arkansas Academy of Physician
Assistants. Representative Graham, if you will, identify yourself for the record and you'll be recognized to present Senate Bill 99. Thank
Zach Gramlich
Unverified
0:41
you, Mr. Chair. My name is Zach Gramlich. I am a representative from District 50, which is the center of Fort Smith. Uh, we're going to be speaking about 2 bills today, but the first bill we're going to be looking at is SB 99, which is going to
Speaker 9
0:56
allow physician assistants to delegate clinical tasks, um, if you look at the bill, it just uh you can see a lot of language that already there about physicians. We just add a physician assistants, um. And of course that they can only
operate uh with drug stuff within the office in which the uh
Speaker 10
1:15
which they are, which they are in and Erin, if you'd like to add anything, sure.
Speaker 11
1:20
Uh, thank you again for having me. This bill allows for PAs to delegate duties to unlicensed medical staff such as medical assistants, emergency technicians, and paramedics. Currently, the law states that only physicians have this authority and as Representative Grahamlich stated, this bill just adds physician assistants to that same language. Uh, what this means is that in practice an MA can only dispense medication under the
supervision of a physician, PAs are perfectly capable of delegating this task to nurses, and it's well within our scope to supervise injections. In my experience, if I'm working in a clinic and the physician isn't physically there that day, I have to rely on the nurse to give all medications or in instances where the nurse is busy or we're short staffed, I have to give medications myself. This does not change what unlicensed staff are authorized to dispense, they would have the same responsibilities they currently have under a physician's supervision and are not authorized to dispense medications that they're not already authorized. to do.
Um, and with that we'd like to answer any questions. Any questions by
Representative R. Scott Richardson
Unverified
2:21
the committee? Representative Richardson, you're recognized for a question. Thank you, Mr. Chair. So did I, did I just hear you say that? Uh, you authorize and you supervise with an injections
Speaker 11
2:29
or something that you just said. What did you just say? So, so the bill would allow a delegation of tasks, the most common one that that is not done, but currently by unlicensed staff like MAS is injections, um, and so things like vaccines or in clinic medications like, you know,
routine IM antibiotics, things like that, um, these are things that they can do MAs are licensed and trained or sorry not licensed or trained to do uh under the super vision of, of a physician, so this would just allow a PA to supervise that same task. So I think, I think to
Speaker 9
3:00
argue it's like, normally how you would have to operate is he knows this kid needs antibiotic and instead of him just being able to tell the nurse, hey, can you give this person antibiotic? He has to go through the physician and the physician has to go back down and so it just eliminates that step for things that are already in his scope,
so it's a little bit more expedited process to get kids and
Representative R. Scott Richardson
Unverified
3:21
individuals care. So you'll be operating so that individual would be operating without the knowledge of the medical doctor on site. He would be operating
Speaker 24
3:30
under your provision and not an MD. So that, that currently um takes place.
Speaker 11
3:36
PAs uh can see patients um independently. We do have supervising physicians that are supervising all care and and attached to our license, um, but they are not required to, you know, physically lay hands on,
Representative R. Scott Richardson
Unverified
3:49
on, on the patients, but what I'm saying is if an unlicensed individual
can do this duty without the oversight of an MD, only a physician assistant. So the,
Speaker 11
3:59
the physician assistant would place the order that MD is still a supervising physician and still assumes responsibility of anything that the PA orders. So let me try it
Representative R. Scott Richardson
Unverified
4:09
a different way. So If you have the ability to give duties to an unlicensed individual. You can do that without going to an MD directly
Speaker 11
4:20
uh with, with this bill, yes, so, so the, the physician would not directly, you know, have to be in the room or order that, um, but the physician is still supervising all care per our license and per our delegation agreements, yes, so
Representative R. Scott Richardson
Unverified
4:32
an unlicensed individual could operate without the knowledge of an MD. I, I, I don't if you've given them the authority and you don't have to go to an MD to give them authority. The authority is based on your protocol, correct? But the
Speaker 28
4:47
granted to us and delegated down from a physician. I'm not, I'm
Representative R. Scott Richardson
Unverified
4:51
not disputing that. What I'm saying is, but at MD would not have knowledge of
a directive that you've given an unlicensed person. So the, the MDs do supervise all care, so
Speaker 11
5:01
that's, I mean, they, they, they would still have, like I said, have authority and supervision over any care that a PA provides. I'm gonna try
to help clarify the question. I think what he's trying to ask is, Is it your opinion, yes or no, that if you give direction to an unlicensed person to administer something that that would happen
Speaker 11
5:22
before the MD had knowledge of it. So that's it, and I apologize, a little hard to answer that question. It's, it depends on a specific uh medical practices, uh, place, some practices and hospital systems require that, you know, MD supervise and sign off on every order, uh, but, but not all do, again, this is just to kind of expedite care and, and, and make a timely manner in the same sense, I think what could help clarify this, um, if I prescribe a, an oral antibiotic that I'm sending to a
pharmacy, the MD doesn't have to. Sign off on that or go through the MD for me to send the medication to a, a pharmacy. So this is just giving medications in the clinic. Does that help
Representative R. Scott Richardson
Unverified
6:04
clarify? Well, but in that situation, the pharmacists would be licensed, trained pharmacists to provide that medicine, correct? Correct. OK. Any
other questions by the committee. Representative Ferguson, you're recognized for a
Representative Kenneth B. Ferguson
Unverified
6:19
question. Thank you, Mr. Chair. Just question I'm curious about
what's the difference between a physical assistant, a physician assistant in an APR. Yeah, that's
Speaker 11
6:28
a great question. So, um, we have similar delegative authorities, similar training, um APRNs are registered nurses first who then go through uh training to be an advanced practice registered nurse, they're trained more on an advanced nursing model, PAs are trained on a medical model that's modeled after um conditions. Um, it's an average of 27 to 28 month uh course that includes over 2000 hours of
clinical um rotations, we are then directly supervised by physicians and are licensed are tied to supervising positions, so all of our patients are receiving care by a physician-led team. Um, again, this, uh, the nurse practitioners did pass a similar bill through this committee, HB 1131, which allows them to delegate tasks to unlicensed uh professionals, and again this is uh we have. You know, similar, similar roles in the clinic. And one more question,
Representative Kenneth B. Ferguson
Unverified
7:19
Mr. Chair. So an APRN would be able to do the same thing that you're
requesting under this piece of legislation under HB 1131,
Speaker 11
7:26
which passed through this committee a few weeks ago, yes. Thank you. Thank you, Mr. Chair. And
Speaker 9
7:33
I would have said something, and you know, we're saying unlicensed, but it doesn't mean untrained. Like these are, these are trained professionals who do work. It's that just to add a little color to that. Thank you for that clarity. Committee, any other questions? See none.
Uh, is there anyone in the audience that would like to speak for or against the bill.
Speaker 9
7:55
See no one representative of you reckon that to close for your bill. I would just add a couple of things. Obviously the goal of this bill is to allow our physicians to be able to do more and to do that, they need someone to be able to take care of all of those tasks and delegate those tasks, and that's what the purpose of this is is to allow our PAs to delegate tasks to give our physicians the ability to do more complex things, and with that, I would motion to pass. That's a
proper motion. Any discussion on the motion? See none. All those in favor say aye. Opposed. No habit.
Unknown speaker
8:31
Are you prepared to present C Senate Bill 101. Two hands, we'll call the rail. Representative McGee. So Representative McGee, no. Representative Ladyman.
Speaker 50
9:03
Representative Lady Man yes. Representative Bentley. Representative Bentley, yes. Representative Ferguson. Representative Ferguson. Representative Allen. Representative Allen. Representative of Pickleton. Representative Pilkington.
Representative Perry, representative Perry, no. Representative Johnson. Representative Johnson, yes. Representative Cooper, Representative Cooper. Representative Richardson. Representative Richardson No, representative in it Representative Richardson No,
representative in its representative in it, no. Representative Long. Representative Long, yes. Representative Schultz. Representative Schultz, yes. It was of more. There was enough more. Representative of more? No. Representative Rose. Representative Rose, yes.
Representative Grahamlich. It was end of Gramlich, yes. Representative Barnes. Representative Barnes? No, representative Henley. Representative Henley, yes.
Representative, your bill's failed. Are you prepared to present Senate Bill 101? Um
Right If you will, identify yourself for the record and you'll be recognized to present Senate Bill
Zach Gramlich
Unverified
11:47
101. All right, my name is Zach Gramlich, uh, representative from District 50. Erin, what all family practice
Speaker 9
11:52
with the Arkansas Academy of PAs. Uh, Cenel 101 is similar to other bills that have been ran in the past as much as that this is another compact that all office and physician assistants to work within this compact, and we as a state will be entering into it. Um, this will establish a streamlined multi-state licensure process through the physician assistant licens your compact, uh, it'll attract retain healthcare professionals by simplifying the licenser addressing workforce shortages, which we know we have in the state, um, and one of the big
things for us is it's going to support our military families. Obviously, Fort Smith, uh, Little Rock, and other places across the state are having, you know, pretty big influxes with military families coming in and what this will do is allow for easier transitions across state lines, um, and it's going to ensure uniform high quality standards for the PA practice. Um, would you like to add anything? Uh,
Zach Gramlich
Unverified
12:42
this bill does not change any current state practice
Speaker 11
12:45
laws and identify yourself for the record, we're on a new bill. Erin Woodall, a family practice PA with Arkansas Academy of PAs. You recognize.
This bill does not change our current. State practice laws and any PEA's practicing under the Compact have to follow all state statutes. It also creates a shared data system among Pongett states where disciplinary actions can be reported, which improve safety measures for the public. And with that, we'd like to
answer any questions. All right, thank you for your testimony. Uh, I'll start because this is inevitably gonna be the first question I think that comes out of the gate, uh, where is the amendment that it gives ALC oversight at the state level
instead of the federal oversight, is that in here somewhere, Representative
Speaker 70
13:28
Graham? Uh, it says page 26, line 11. Um, so if you want to flip to
Zach Gramlich
Unverified
13:37
that with me. Um, yeah, it's the last section in the bill, the board will shall file and propose
Speaker 71
13:43
a rule with the Legislative council under 103309 sufficiently advanced, etc. So legislative council have. Thank you, sir.
Any other questions by the committee, Representative
Representative Denise Jones Ennett
Unverified
13:54
Bennet, you're recognized for a question. Thank you, Mr. Chair. Um, which states are already in our planning to be part of this compact. There
Speaker 11
14:01
are 13 states that have already passed, which include Tennessee and Oklahoma. 15 others including Arkansas have filed, which includes Texas and Missouri, so we're hoping that we're going to have, you know, a lot of border cities, um, be, be apart. Thank you. Any of the questions by the committee?
All right, we don't have anyone signed up to speak. Is there anyone in the audience that would like to speak for or against
Zach Gramlich
Unverified
14:38
the bill. Seeing nonpresentative, you reckon that's close for your bill. Uh, thank you so much. Obviously
Speaker 9
14:41
this is going to be great for our community. We're going to get more, more PAs into the state and allow more flexibility for a lot of people with that, I'd like to motion to
pass. That's Yes. Our mics have quit. They're they're back. See no, congratulations you have passed your bill.
Unknown speaker
15:02
Uh, thank you, Chair. Thank you committee. Representative Mayberry, you're
Representative Julie Mayberry
Unverified
15:32
recognized to go to the end of the table. Which bill would you like to
start with? I know you have 3 today. we've already discussed. 1241 OK, we're going to hand out an amendment on 1241. Give committee a minute to review that amendment, and you'll be recognized to present.
Committee, this bill also has a fiscal impact statement, so we'll give you that as well and give you a second to review that.
Representative Mayberry, if you will, identify yourself for the record, and you will be recognized to present the amendment
Representative Julie Mayberry
Unverified
18:26
to House Bill 1241. Thank you. Uh, State Representative Julie Mayberry District 97, um, 92. What am I? Sorry, it's been one of those days. I've had very little sleep last night, so, um, so the, the amendment, as you may
recall, we were here discussing um a little over a week ago, and we asked for a fiscal impact statement. You're getting that right now,
um, I'm, I'm told this morning there might even be some other suggestions of an amendment, and, and I'm willing to continue to work with this committee in any way possible, but I do very much want to have the discussion today on this amendment. And continue the discussion. It is that important, and we have families who are here who would like to testify, so, um, let me just explain a little bit of what what's in the amendment. First of all, we're basically taking out section um on, on
page two lines 6 through 10, essentially we're taking out the complex medical conditions um information there, um, and we are also adding in, um, not only the dental school that we talked about, but also adding in academic medical institutions, um, we also changed where it said 12 years of age or older, we moved it up to 18 years of old or older and we also um Uh,
Change the um. Reimbursement rate we had said that it was 1% above the actual cost and we're now just saying 100% and I believe that there might have been some discussion earlier this morning on maybe another way, um, but I'd like to go forward with this right now, if we could adopt it so we could discuss the bill and if there are other suggestions, I am open to making this work, and I appreciate the the committee's time on such an important issue. Any questions on the amendment?
Seeing nonpresentative Bentley, you have a motion. All right, she has a motion to adopt the amendment. That's a proper motion. Any discussion on the motion. See all those in favor
say aye, opposed. Congratulations, your amendment has been adopted and you are now recognized to present House Bill
Representative Julie Mayberry
Unverified
20:45
1241 as amended. Thank you. Um, members, we, we had
this discussion a little over a week ago. Um, we still had the needs. There are more families here who want to testify and explain, you know,
the concerns. I'm going to let our two doctors who are here kind of share a little bit about um what's taking place between now and then, um, we
can talk a little bit about the fiscal impact of this as well, but I'll let y'all introduce
Speaker 100
21:15
yourselves. I'm, I'm James Hunt. I'm a, a physician here in Central Arkansas and the father of a young
Speaker 102
21:20
man with Down syndrome, thank you, uh, committee members for allowing us time again today out of your busy schedule.
Um, you recall in an earlier conversation over this bill about the desperate need and and how some of us lived that desperate need and there are, there are many of us in Arkansas, um, without access to basic care for our loved ones, um, especially if that basic care requires deep sedation or general anesthesia to accomplish oral health care, um, in general, and, and oral health care. specialists in particular in this bill we hope is a is a
bridge to that to, to better provide the the very safety net care that, um, uh, uh, uh, our, our state pledges to and and basically in the, in the Medicaid format. Hi, Ashley McMillan here. um I'm
Speaker 104
22:17
a dental provider here in Central Arkansas, have been for the past 10 years. I was here last time, so thank you all for your time and hearing us again. Um, the only thing I will say since then just as I've thought about it is um just.
Allowing us to create a system because right now there is no system for these folks, um, right now the only way folks get care is if they're lucky. And what I mean by that is they happen to have other comorbidities that have necessitated the need for the OR and we just get lucky enough to piggyback the procedure in the OR and add some dental care for them. So there is no system and, and we just want you to help us create a system and allow us to collect good data so we can make informed decisions in the future.
Chair
Unverified
23:05
and how to do this the right way. So thank you. Take questions.
Representative Ryan A. Rose
Unverified
23:14
Any questions by the committee, Representative Rose. You're recognized for a question. Thank you all for coming back with us today, um. the discussion that we
had the last time around. Um, and I can't remember if it was either of you doctors who testified or other families. So if you don't remember, it's totally fine. But there seemed to be some discussion points on some policy
changes that had happened with, was it Arkansas Children's to where The there was a new restriction or limitation on the age that they were able to provide this kind of care to. And then after the meeting, I had some folks, and children
who were like, This is news to us. Have you guys had any conversations since then on that.
Speaker 100
24:02
also had conversation after the meeting with somebody who, uh,
Speaker 102
24:08
the testimony given by patients last in the last meeting was correct. Patients have been receiving information about 12 years of age and older, as late as this last month, um, the, the The change to age 18 and under is a welcome change and is awesome information that uh many of us in, in the community via social media are happily sharing with families since the last
Representative Ryan A. Rose
Unverified
24:39
meeting. So for those who maybe don't recall or weren't in the room the last time around. Can you kind of summarize Exactly what the policy is just so that we're aware of what age. They, they do now provide the policy communicated to me after
Speaker 102
24:53
the end of the of the meeting is that they will take patients up to the age of 18. And it had been understood that they were stopping it at 1212. So, um, if you
Representative Julie Mayberry
Unverified
25:06
know if Sorry, if you notice we did change the age in the bill to
18. I saw that adult, adult population is what we're talking about. I wondered
Representative Ryan A. Rose
Unverified
25:14
if that was reflective of those conversations and that that doesn't really have much bearing on where I'm at on the bill as much as I just, I was hoping that that had been
clarified and that they were providing those services up to the age of 18 and, and,
Speaker 100
25:27
and um, I, I for one, am ecstatic that the changes occurred. Well, thank you for that. Thank you, Mr. Chair. Representative Johnson, you're recognized for a
Representative Lee Johnson
Unverified
25:37
question. I want to first of all, thank
you to all of y'all, Julie especially Representative Mayberry, I
appreciate all your hard work on this and your willingness to be patient and listen. It's a difficult issue that I think is important that we address, but there's also a lot of nuances to it that make it a challenge, and it's it's an issue everybody's passionate about and appropriately so, right? So I don't want to take up a lot of time with questions. If I heard you right, you are amenable to more amendments around the reimbursement. structure and you'd be willing to work on that more if if there's, if we're making progress, it feels like we maybe are. Is that correct?
Representative Julie Mayberry
Unverified
26:12
Absolutely. You know, I, I, we welcome the input. We want everybody to feel good about this bill. Good. Well, I'm
Representative Lee Johnson
Unverified
26:17
interested in hearing the testimony. I may have more questions after, but I'm looking forward to the testimony from family. Thank you. Any of the questions
by the committee. So Representative Mayberry, I think what we'll do is we've got several folks that are signed to speak for the bill. Let's let those people testify and then before you're recognized to close, we'll bring you back to the end of the table, uh, for a little bit further discussion or maybe questions by the committee
if you're OK with that. Perfect. Thank you. All right, we're going to start testimony. Katrina Robertson. If you will, identify yourself for the record any organization that you're
Speaker 132
27:05
representing and you're recognized to testify. Oh, I am Katrina Robertson. I'm a resident of Garland County and I am mother and guardian to my
Speaker 134
27:14
son Noah, who just turned 22, but is on the cognitive level of about a 3 to 4 year old. Many of you probably recognize me. I've been in here giving testimony before, uh, I, I will, you know, deviate a little bit from my testimony here and say about the whole age 12 or 18, they will take them up to age 18. The problem is, is that, um, there is so many that they can't get them all in so they prioritize up to age 12, and if you're over age 12, yes, they
can see you, but they really don't see you because sometimes it'd be 89 months out. Before they can get you in, they prioritize to age 12, so that's the The distinction there. But I'm here obviously I support House Bill 1241, which if passed would ensure that there's Medicaid reimbursement for dental and anesthesia for these more complex dental cases, uh, specifically involving adults with intellectual disability. My son resides at the Boonville
Speaker 132
28:15
Human Development Center. I serve as the
Speaker 134
28:17
president for the board there for the family and friends of care facility residents and I'm also part of the executive board of the statewide group. Through my advocacy for this population, I've received numerous inquiries from parents seeking assistance to obtain dental services for their disabled adult children. It's common for individuals in this population to struggle with even the most routine of dental care. You simply cannot get in there. mouths without sedation.
Uh, previously, as we talked about Arkansas children's did service even adults, but they quit a few years back and capped it off, um, UAMS, I believe, looked into piloting a program, but it's been discontinued. There are a few dentists in our state that will provide the service, but they do not accept Medicaid. And you know, this is an essential service. Uh, there seems to be an understanding that sedation is often required for children for to do dental work, uh, but those with these
severe intellectual disabilities are not going to outgrow this, that service is still needed. Unfortunately, the only option for most of them is to wait until an emergency arises, uh, such as an abscess, and now we've got a significant medical concern and then that's the only way that they can, uh, then get the sedation to only have the tooth pulled. There's no preventative care whatsoever. You know, poor dental health can lead to serious life threatening health issues that could have
easily been avoided. Um, some of these, and one of the, the complex things that some of these individuals have lots of other medical issues and a practitioner has to weigh the the risks of the anesthesia with the, the risks of other medications and issues they have, but like the, the one provider mentioned some of them are quite lucky that they actually have comorbidities that allow them to be sedated for those issues, and they kind of get in their mouth at the same time, um, y'all, it's just that's not um adequate, um, and it's
unacceptable that they cannot receive just regular preventative dental care, um, unless they're in a life-threatening situation. And even though I've testified to you before on behalf of residents at the Human Development Centers, uh, there is a much larger population that reside in the community that depends on these services. And it's mainly those parents who have contacted me for this specific service and in seeking it. So I support, support House
Speaker 132
30:53
Bill at 12:41, and y'all, this is only a small step in getting the service these individuals need. Are you open
to questions, ma'am? Any questions by the committee? Seeun, thank you for your testimony.
Next we have Samantha Crocker signed up to speak for the bill.
If you were both identify yourself for the record and any organization you represent, you'll be recognized for
Samantha Crocker
Unverified
31:40
your testimony. My name is Samantha Crocker. Is your button on? There we go. OK, sorry about that. Uh, my name is Samantha Crocker. I am the uh full-time
Speaker 143
31:48
caregiver and a parent of a 13 year old son named Eli, um, who is on the severe end of the autism spectrum and has a lot of other diagnoses that go along with it, that the list is
extremely long, the older that he has gotten, uh, the more longer the the list for his diagnosis have, have went. So it's, it's extremely long. Um, But I'm here today to represent him as well as um his only friend that he's gained, uh, in the last several months who happens to be 15 who struggles with the same issues, um, as well as my nephew who is 7 and my niece who is 5, now they're
much younger than my son, but I'm, I'm, I'm advocating on behalf of all of them because all of our children will grow up, um, to become adults, um. Learning that it, it changed from 8 from 12 to 18 is a little bit of a relief. Um, however, um, going off of what Katrina mentioned, um, My son is 13 and I have noticed through uh Arkansas Children's, the last several months that we have went to the dental facility
when I have mentioned my concern regarding uh my son's oral care, they have continually said, well, we're gonna hold off, we're gonna hold off, we're gonna hold off. It has been 2 years since he has had any set of thorough x-rays, um, or dental cleaning because he simply won't tolerate it, um. His behaviors include elopement, flat refusal, um, and avoidance. He's, he is, his anxiety level,
his, it just, it skyrockets. Um, we have worked day in and day out and I'm going completely off script, so um, we have worked extremely hard, um, as parents when it comes to any invasive procedures, and a lot of people don't believe that that routine dental care. Our, are is a Invasive procedure, but for individuals with disabilities, especially an individual like my
son, um, the sheer sight of the dental chair itself is enough. To make his anxiety go through the roof. Um, We sit in a chair off to the side and we have worked very hard, um, to allow him to get to the point where he's able to open his mouth and tolerate basic tools, um, but till this day. He has not had a thorough set of x-rays or dental cleaning
without being sedated. He has been sedated on two occasions, um, And it has been through my constant Um Advocating for him and our concern for him, um, which is why they were finally willing to do it, um, when they did sedate him, they removed some baby teeth because adult teeth were growing in, um, the next time they found two cavities, um, we go next month. Um, and I'm scared to death
about what they're fixing to tell me when I go next month because he is 13, he has, he hasn't had cleaning or X-rays done in 2 years. So when I go in next month, now that I know that it's 18, I'm, I'm fixing to start. Advocating again like we we need to get him, we need to get him taken care of oral hygiene directly connects to so many other health concerns as, as they get older, um, and for children with disabilities that grow into adults with
disabilities and adults with disabilities that are already at this point. Their health can be dramatically affected. Their, their mental health can be affected. The emotional well-being can be affected. Um, the only option that we as parents have been provided with. Other than sedation has been strapping him down by his arms and his feet and laying him on a board.
For us as parents, we believe that's just absolutely inhumane. The trauma that it could cause, the fear that it can cause, um, It just, it's just unhealthy, um, and if you, in my, in my thought process, if you were to do that just once, the battle just to get him into the dental office, the next go around would go up that much higher because he would already have that traumatic experience tied to it.
Um, so for that reason I am, I am a very strong advocate of this bill, um. I'm, I'm open to any questions or concerns that you may have, um, I'm an open book when it comes, when it comes to our son. Um, we have traveled, uh, Across state lines, we have, um, had both private insurance as well as Medicaid. We have. Uh, took out loans, uh, to get the services our son needs, we
have uh put services on credit cards, um, we have done everything we could to help get our son the care, um, we're doing it at home, we're doing it in therapies that he has. I'm setting it up in goals, um. But things like this, this bill is so vitally important, um, to not only my son, but every individual with special needs. Um I believe it's our
responsibility to take care of the disabled. It's our responsibility to take care of the, of the elderly, um. And When I found out that Arkansas children's and all of them essentially were closing the door on this up until this morning when it was told, told to me that it was 18. My heart Dropped my heart dropped like my, I don't know without this bill, what that would mean for my son.
And, and so that's why I'm here today is to advocate for my son and and anyone and everyone that I know and all those special needs, uh, families, all those special needs individuals, both children and adults alike. Thank you for your time. Sorry, I'm a little emotional. You did a great job. No problem. Any questions by the
committee? So then, thank you for your testimony. Thank you very much.
Teresa Dodson
Unverified
38:47
Ma'am, would you like to testify as well? Yes, I did sign up to testify. We just wanted
to sit together for emotional support. Hey, that's completely understandable. What can
Teresa Dodson
Unverified
38:55
you tell us your name? My name is Teresa Dodson. I am a mom as well as a full-time caregiver to Nathan and almost 25 year old young man with autism and intellectual disability. I am not a public speaker, so I apologize on the front end if I get emotional or if my voice shakes, but I'm gonna try to get through this the best I can. Um, Nathan has not been able to access any dental care since September of 2022.
I'm here today as an advocate for him and all of his peers who have developmental disabilities and are not currently able to access dental care in our great state. Access to dental care for adults, and now many children with developmental disabilities has become almost unattainable in Arkansas. When I decided to advocate for these services for my son and his peers. I was not initially able to understand how we went from having access to sedated dental care at Arkansas Children's Hospital to suddenly
not being able to access dental care at all. I recently began to understand that this is all due to funding, or should I say a whack thereof through my advocacy efforts, I've discovered that we have many fabulous dentists in our state who want to provide the much needed care for this population of adults and children. In trying to do so, they have a lost money. Many of these providers have told me that they have been pleading with DHS for years to do something to help them take care of the most vulnerable individuals.
Obviously, their pleas have fallen on deaf ears. I have learned that DHS has not increased Medicaid reimbursement rates to dental providers in 18 years. Currently, Arkansas Medicaid will only pay for sedation dentistry for individuals under the age of 21. However, with uh Arkansas Children's Hospital, and we're accepting them to age 18, it actually stops at age 18 because nobody can find the services. My son functions at a level of about a 3 year old and he will
most likely never outgrow the need for sedated dentistry. DHS has also capped dental care for adults at $500 a year, that will barely cover the cost of a deep cleaning with X-rays, realizing that this crisis was all about funding, I chose to add my son to my personal dental insurance, hoping that this would provide him with better access to care. What I found is that even with private dental insurance, there is no coverage for sedation, even if it's medically necessary in order for
him to receive dental services. There are also very few providers who have the equipment and the staff to provide anesthesia in an office setting. Just yesterday I was fortunate enough to locate a provider in North Little Rock who will offer these services in an office setting for private paying individuals only the minimum charge for anesthesia for dental cleaning and x-rays is $800. That would be just the basic minimum for the anesthesia and then if he needed additional
work while he was in there, the anesthesia costs would be even higher. This is simply not attainable for many Medicaid recipients. Access to dental care should be a basic human right. We're not advocating for special services or special treatment we're advocating for this population of children and adults to be able to get one of their basic human rights met. Um, I know there's been some talk about the dental school maybe not being the best possible, um, solution, but
right now it's the absolute only solution that we have, we're asking you to please, please consider this bill and please help us obtain the much needed services that our families need. Thank you for your time today. Thank you for your testimony. Any questions by the committee? See
none. Thank you both for being here today. Thank you. All right, we have one
more, uh, person who signed up to speak for the bill, Stephen Berry.
Samantha Crocker
Unverified
43:05
If you will identify yourself for the record, any organization you represent and you're
Steven Barry
Unverified
43:11
recognized for your testimony. Uh hello, my name is Steven Barry. I'm here in support of my brother. My fraternal twin brother Scott was born with Down syndrome, uh, one minute after me. And I thought it would be good to hear not just from a parent's perspective but also from Other family members too.
Without my brother, I don't think I'd be the person I am today. He's taught me to be A better person to show empathy. To bring kindness to people. To make a difference in the world. Without him, I wouldn't have been inspired to pursue a career in psychology. And I think a bill like this is to Pay tribute to those who Have Made an impact on the lives of
family members with special needs. It's the Show them how much we care to show how much We want them to have the same support and treatments that We're able to have. Things that we may take for granted. Uh, my brother, When in a dental setting or even in a medical setting would Uh, demonstrate what my line of business would call a fight or flight response. Uh, he gets scared.
And As a result, it's Basically impossible for him to receive dental care. Recent research suggests that this is not a common phenomenon. This is something that Parents have constantly reported over the past several decades. This is something that If not addressed risks. Long term medical concerns and issues, uh, gingivitis, for
example, is of increased risk here. Again, without my brother, I wouldn't be who I am today. And Again, a bill like this, if passed would allow us to. Not only support those with special needs, but the family members of those with special needs. Because it's Those people who make us family members who we are and allows us
to go out into the community, into the state. And to best serve one another. Thank you for your time. Thank you for your
Samantha Crocker
Unverified
45:50
testimony. Any questions from the committee? Say no, thank you for being here today. Thank you. Is there anyone else
in the audience who didn't sign up that'd like to speak for or against the bill. You're reckon to go to the end of the table. If you
will identify yourself for the record in the organization you represent and you're recognized for your testimony. Yes, sir. Thank you,
Speaker 158
46:11
Mr. Chairman and members of the committee. I'm Billy Tarpley. I'm executive director of the Arkansas State Dental Association, and I've received several texts from those of you at the table. I just wanted to make it clear that the dental association fully supports this bill. The the problems that you've heard described today, it's kind of like a jar of marbles and every marble and that bowl is a problem. with Medicaid. This is one of the biggest pro this is one of the biggest marvels in that bowl, and I really, really hope
that you can hear the emotion and the frustration and the concern that's been expressed today and take what you've heard and multiply it by 100, and that's what those are the kind of problems that we hear and it all goes back to inadequate Medicaid funding. I think you heard Ms. Dodson say that it's been 18 years since we've had a Medicaid fee increase on the dental side. We thought managed care would handle that, managed care did not. So really quickly, now we're back in a fever for service environment that's required even more, uh,
challenges on behalf of not just general dentists, but specialists, uh, as well, one of, one of the people I go to on this issue, you told me the other day and he's very uh accomplished and experienced in treating this segment of the population and one procedure can take up to 4 hours and in some cases the whole procedure. begins when they pull into the parking lot and the preliminary portion of anesthesia is delivered. I'm not a dentist, so I'm, I'm getting out of my area,
but it can be very, very complicated. We have one provider uh who has to use Botox and injections into the jaw to even make it possible physiologically for the patient to open their mouth, so this is not like you and me going to the dentist for a cleaning or a filling. This is a time intensive extensive uh experience required. set of procedures that are needed and people like Dr. Hunt and like other providers that
provide that care, uh, in my personal opinion are to be applauded because this is not an easy thing that they do. So Mr. Chairman, thank you. I just wanted to make those comments on behalf of the association. Thank you for your testimony. Any
questions by the committee? So Nunn, thank you for being
here today. Is there anyone else in the audience that would
like to speak for or against the bill. See no one representative Mayberry, if you will, go back to the end of the table and we'll continue some discussion and maybe questions by the committee if you're OK with that. I
Representative Ryan A. Rose
Unverified
48:48
Representative Rose, you're recognized for a question. Thank you, Mr. Chair. Uh First off, again, thank you, Representative Mayberry. um, I, I am guilty, which you are not, but I'm guilty of getting tunnel vision when I'm on an issue, and I appreciate how workable you've been and and continuing the conversation. And with that said, I have a couple of questions for DHS on this if we could have them come to the table. Someone from DHS in the room that can come to the end of the table.
If you will, uh, both please identify yourself for the record. Representative Rose be
Representative Ryan A. Rose
Unverified
49:50
recognized to ask his question. Good morning. I'm Elizabeth Pitman, director for division of Medical Services. Uh,
Speaker 164
49:55
good morning, Janet Mann, uh, deputy secretary,
Representative Ryan A. Rose
Unverified
49:59
Medicaid Director, DHS. Thank you both for coming to the table as we're kind
of navigating the challenge. I think everybody's aware that there is a very critical need for this, this group of folks who are, um, have a particular
Challenge in getting dental work done or exams done and uh I'm of the understanding that there's some ongoing, maybe negotiations with a hospital in our state that would cover this issue. That DHS is Maybe in line with being able to to make sure that This kind of Scans and exams and procedures are going to be covered. Is that something you can speak to?
Speaker 164
50:45
Um, yes, sir. So that is, that is accurate. We've been working with UMS on that. I'll I'll let Elizabeth speak to some
Speaker 168
50:53
of the details. Yes, sir. You're absolutely correct, and Jane, it's correct. We have been working with UAMS when we
Speaker 170
50:58
heard about the difficulties with children's and particularly for children 12 and up, we approached UAMS, and they have been working with us to develop a dental clinic. There have been some hurdles. They've seen a few patients so far. Um, the primary hurdle is working through the reimbursement, um, as I think we've said before
it's been very difficult to get an accurate reimbursement for these services. We are very close on the fee for service side to having that worked out through what we call a single case agreement, and then we will negotiate with the passes as well to make sure that that those things are in
Representative Julie Mayberry
Unverified
51:31
place. And I, I'm sorry, can I just interrupt and say that our amendment actually
added in academic medical institution based on feedback from UAMS and so they would be included in this, just making that clear. Thank you a little, little latitude to kind of go back and
Representative Ryan A. Rose
Unverified
51:48
forth here. You. Thank you. Um, and I, I, I
feel bad because I think one of the things that you did was to try and appease some of the concerns with raising the age to 18. But what I just heard earlier and, and I'm sure you guys could speak to this. Maybe we should give children an opportunity to speak to this too, but that there's this prioritization towards age 12 and under. And so if we, we do this at age 18, then does that stop you from being able to provide service
for those between the ages of 12 and 18, say they can't get service at children's. They come to you and now we say, hey, we're working on this just for 18 and above.
Speaker 164
52:32
Can you just kind of speak to that? Yes, sir. So, um, I, I don't believe it will limit um service from 12 to 18 under EPSDT Medicaid program is obligated to cover for those services and we, we want to cover those services. I do believe in some of the conversation with the bill we
had wanted to, to lower the age just so there would not be any discrepancy about them getting the service. Over 18, um, then they become adults and it gets a little um more difficult. To treat and so that is probably why that number was, was chosen. Um. I, I'm,
Representative Ryan A. Rose
Unverified
53:08
I'm of the sincere belief that what's being done here is essential and necessary. We've got to take care of these families and these individuals, um, from what you're trying to
accomplish with UAMS or any other hospitals or facilities. Where does DHS stand currently on the language that that we're looking at.
Like if we're to pass this, does this help? Does this prohibit? Are you guys neutral?
Speaker 166
53:35
I think it's a combination of neutral and in favor we
Speaker 164
53:39
have given some feedback to some of the amendments and have been trying to to work on the reimbursement language. I think we've come to some ideas or some conclusion. I don't want to
speak for anyone else, um, I think one of the biggest struggles is trying to identify a how to reimburse and so when we were looking at the UMS data, it was ranging from 2000 to 3. 13000 depending on the acuity of the episode, so we, we try to do something in the middle, knowing that some of that could be high, some of that could be low, so I think coming to a different number to build up to and then seek prior approval after that
for the complexity of the acuity of the of the need for the patient, it is something that we could work with. We're also trying to find a way to see how it could be easily billable, um, with a claim. Um versus, um, a lot of back and forth every time they when they saw a patient. Well, I, I don't think there's anybody
Representative Ryan A. Rose
Unverified
54:42
more committed than Representative Mayberry and and her witnesses at the end of the table to seeing this
resolved, and I want to let my colleagues jump in here. I'm sure they have some questions as well, but I think we kind of are all in
agreement that we want to see a solution to this, and the families I'm certain would, would like to see it sooner than later.
And so I think we're my, my goal is to see how do we do that and, and where is that, but I want to
Chair
Unverified
55:09
let other folks jump in if they have questions. Representative Johnson, you're recognized for
Representative Lee Johnson
Unverified
55:12
a question. Thank you, Mr. Chairman. So if I'm hearing you correctly, uh, would you say it's fair that you're committed to continuing to work on trying to come up with language that's um Fair in the reimbursement module and also like like um.
Actionable, right? Something that could be facilitated, it doesn't feel to me like we're at an impasse on these discussions. Do you do you feel like we're still making
Speaker 166
55:36
forward progress. Yes, sir, I do, I do think there's progress being made. I'm not, I'm not aware of an impasse. I think, um,
Speaker 164
55:44
I think one of our concerns that we had voiced was um not just one institution I think that was why they added the language for other academic institutions, hoping that um this could actually be delivered at
multiple academic institutions across the state which would help with access to care and travel time and then I think working through the reimbursement, um. In making sure, you know, um, that I, that what we can agree to that we can deliver in our budget and so those are the priorities. That's good. Thank you. Representative Ferguson, you're recognized for a question. I think Representative Johnson
Representative Kenneth B. Ferguson
Unverified
56:29
may have asked my question, but I want to be clear, the conversation that's going on between DHS and your UEMS. How does that affect other parts of the state, rural Arkansas, specifically. Thank you for
Speaker 164
56:47
one. I think with wanting um to open it up to academic institutions and because of the sedation feature and the complexity of the cases we were hoping that multiple academic institutions across the
state from Fort Smith, Little Rock, Jonesboro, and others if, if, if they're available, can deliver that care. I don't have a specific answer on, on rural Arkansas. I, I was. Focused on multiple places at least for shorter travel time in the academic institution was a was a good compromise. In my understanding. OK. Thank you, Mr. Chair. Representative Johnson, you're recognized for a question. Just, just so we're clear, academic institutions also includes the dental school, right? I mean,
Representative Lee Johnson
Unverified
57:32
we, it's, it's, it's all of these places rowing the boat in the same direction. It's not that we need just your MS or just the dental school is that the idea would be to support any location that
could provide these services in the agreed upon manner in a
Speaker 164
57:48
safe way. I, I believe so. When I say academic would be any type of teaching clinical, um, studies from um a DO school to a med to a med surge medical school to a dental school. If I said it correctly, so.
Representative Ryan A. Rose
Unverified
58:04
Representative Rose, you're recognized for a question. Thank you, Mr. Chair. Um,
and I understand you may have to speak more broadly before speaking in the hypothetical specifics because it sounds like you're still in negotiations. Um, one of, one of my concerns would be what would disqualify A patient or a family from being able to be reimbursed. What, what would, what would preclude um
Somebody like the doctor's son at the end of the table. What would, what would cause UAMS or DHS like, sorry, we're not going to be able to pay a reimbursement on this, figure it out,
and I know that's not how you say it, but essentially that's what they're left having
Speaker 191
58:52
to do. I, yeah, because I'm not sure you, you said the answer in broad versus or you can be very specific. I
Speaker 170
58:58
just wanted to let you, I can't be very specific, um, because it is a case by case determination. We the only real disqualifier for this would be
medical necessity or in this case dental necessity. Medical is just a term we apply to all services, but if the, if the services were determined to be necessary, and we, you know, look at the case review provided by that provider, UAMS or the Academic medical Institution in question, uh, we. Don't look at the diagnosis. We don't look at the age of the person. We look to say, is that service necessary for that individual, particularly if they're under 18 because we have to cover any medically necessary service for children, um, and then if it is, we would cover it.
Representative Ryan A. Rose
Unverified
59:39
A question for the witness at the end. Doctor, Doctor, and I'm sorry I forget your last name. I'm just,
I'm curious with the testimony we've heard from you, uh, with what you're hearing now, does any of this, is this, is this offer you comfort or hope. For the challenges that you and your family and many others are facing, or is this just kind of off in left field and Just kind
of curious your thoughts so far on what we're hearing from DHS. Conversation's awesome. OK,
all right. That's what I'd like to hear. Thank you. I'm gonna hop out. Any other
Representative Lee Johnson
Unverified
1:00:19
questions by the committee, Representative Johnson? I just, I would like to hear from children before we close testimony because we have had a lot of discussion around coverage. Is it, is it 18, is it 18 under? What are they prioritizing a certain age. I think we've heard clearly from DHS that they're willing to they they're not willing, they have to cover anyone under 18. So if the if the coverage is there, just, just being sure that
Children's Hospital is uh definitely, you know, in a place where they're prepared and able to take care of that age
group. We'll ask our friends from Children's to come to
the end of the table. If you will identify yourself for the record, and you'll be recognized
Speaker 92
1:01:00
to answer Representative Johnson's question. Sure, Sheena Olson, vice president of government relations, Arkansas
Representative Lee Johnson
Unverified
1:01:05
Children's. Yeah, and just the specific question, it seems like there's
been some conflicting testimony around information relayed back and forth and maybe some of the testimony was outdated, sincere but outdated, just trying to get some clarification on what we're doing presently with regard to IDD population and dentistry, and not just dentistry, but sedation dentistry as well. And um what you're, you know, what your thoughts on moving forward on this
topic for children. First of all, I do want to
Speaker 92
1:01:32
um. Say to those families that have been confused or concerned or gotten feedback. I mean, what
Speaker 202
1:01:42
you hear is sincere and um I want to recognize that because there, there are serious issues for Arkansas children's, we did see adults for a long period of time, several years ago, it got to the level of capacity and our clinicians had clinical decisions around ability to as pediatric anesthesiologists, pediatric dentists, whether they were able to see this. So that policy changed several years ago. Um, my understanding is it kind of went from different age
ranges to 18, um, again. I want to be clear what everyone has told me and that I our official policy is 18, um, as for the prioritization, I was radio in headquarters just a while ago to see is this the situation, so I, I don't know, but I have been told that we are trying to see these patients as we can. We are a very limited capacity organization, dental is not a huge clinic in Arkansas Children's. We have had provider
turnover. And we are trying to meet this need as best we can, but we, we recognize to all the testimony today, we are not the solution for what we've gotten. We're part of it. We're committed to being a part of the solution, but that is where we are today. Any other questions by the committee,
Speaker 204
1:03:05
Representative Rose. Thank you, Mr. Chair. Um, and you may have articulated it, but I just want to follow up. Can
Representative Ryan A. Rose
Unverified
1:03:15
you specifically answer, uh, with regards to that 12 to 18 range. Are you guys prioritizing and I understand you may have to triage some of this, but this is something for us to have an understanding of. Are you prioritizing 12 and down, and if that's the case, you know, do we need to have a make sure we have a better provision for 12 plus instead
Speaker 202
1:03:34
of 18+. So Again, it would be all a hospital operational case by case situation. What I am told is that we are not prioritizing. I don't want to dispute.
What any experience has been, so. If, if you've had a different experience, I recognize that, but that there's always a prioritization around OR space, sedation, ability for anesthesiology to be on call. I mean, there's always some situation, but as a policy that has been articulated, we see up to 18. So, um, if there is some kind of balancing like we do on everything, I mean we have to make those decisions every day
on what clinical service gets provided when Just by capacity, so the limiting factor is capacity. Thank you, Mr. Chair. Any other
questions by the committee? See nonpresentative Mayberry before you're recognized to close for
your bill. Would you like to uh continue any discussion? Is there anything you'd like to do as we move
Representative Julie Mayberry
Unverified
1:04:42
forward? I just, uh, I, I do believe, first of all, thank
you, thank you for the fantastic questions. Thank you for being willing to listen and take in the information and maybe even help me work on a solution. This
has been complicated trying to get everybody in the same room at the same time is almost impossible because everybody else has other bills and and things. too. So, um, you all are helping us come up with a hopefully a great end result, and I don't mind holding this bill one more time and seeing if we can come
up with a better pay structure that meets the needs of DHS, but also takes care of our most vulnerable population, because I think you see that
there is a real problem and we need to address it and we need to fix it. Thank you,
Representative. I think that you can see the committee is very supportive of what you're trying to do, and we definitely want to make sure that we as a body do what's right for those constituents and those Arkansans. So your request is to pull this bill down for
now. Would you like to make a comment on that, Representative Bennett? Thank you.
Representative Denise Jones Ennett
Unverified
1:05:49
Um, I'd like to thank you for bringing this bill forward. I too have a son my um This brings back a lot of memories, my fraternal twin, I have twins, my fraternal twin has autism and we have dealt with sedation with dentistry, um. Without belaboring that I, I'm in full support of this, and so if I can help in any way, please let me know. Thank you. Representative, we want to work with you on this bill. We
want to get it right. Um, so we'll honor your
request to pull that down. Anything that we can do as
a committee to be helpful, just let us know and uh we look forward to you bringing something back to us. Thank you. Thank you, ma'am. I have 2 other bills, so if you don't mind, we're gonna have you, have you step aside Representative Wing is gonna be recognized. Um, he's got to be in another committee and then We'll bring you right back to the end of the table. Representative Wing, are you prepared to present House Bill 1505? that You have an amendment for that bill? We do, yes. All right, uh, staff's gonna pass the amendment out. We'll give the committee
members just a second to review that and then you'll be recognized to present
Representative Carlton Wing
Unverified
1:07:04
your amendment. Sounds good. Thank you. I was Remarkable. Yeah, it's a great thing. That's
Speaker 218
1:07:07
amazing. OK very helpful. Yeah. OK. Yeah I try to use the iPad for a while, but it's
Speaker 222
1:07:19
too slick. This has a little bit more grit to
it. It's just the emergency clause
Speaker 26
1:07:33
and the co-sponsors. Yeah All right, committee, you've had an opportunity to review the
Speaker 83
1:07:46
amendment Representative Wing, if you will identify
yourself for the record and any of your
guests have themselves identify themselves for the record, and you are recognized to present
the amendment to House Bill 1505. Thank you,
Representative Carlton Wing
Unverified
1:07:58
Mr. Chair. My name is Carlton Wing, state representative, District 70, which is North Little Rock and Sherwood and got a couple of guests here as well. Thank
Speaker 227
1:08:08
you, Representative. My name is Matthew Stallings. I'm with the Arkansas Professional Firefighters. John Wilkerson, general counsel of the Arkansas Municipal
Representative Carlton Wing
Unverified
1:08:15
League. And what this amendment is is simply is an emergency
clause so that we can get this coverage sooner and a list of
co-sponsors. That's it. Any questions on the amendment? Seeing knowing what's the will of the committee, we have a motion to adopt the amendment, Representative Richardson, all those or any discussion on the motion. See none all those in favor, say I opposed. Congratulations, your amendment's been adopted and you are now recognized to present House Bill 1505
Representative Carlton Wing
Unverified
1:08:44
as amended. Thank you very much, Mr. Chair. Thank you committee. House Bill 1505 is very, very similar to a bill that we passed in the last session, which was House Bill
1302, which became Act 537. Uh, what we're doing is addressing traumatic experiences that our first responders have and how can we best serve them after they have witnessed such an event. The average person has about 1.5 traumatic experiences in their lifetime. These are serious. cases of high trauma. So the average person has about 1.5 of those in their lifetime. The average first responder in the course of their career has about 800.
So how they process this, uh, has a direct effect on how our communities and cities are uh are protected and governed. We have an opportunity to take care of our first responders, and so what we did in the last session was we passed a bill that provided uh mental health care for those first responders who serve us. Uh, we passed that with a sunset clause because we wanted to see how it would work and uh and and how what kind of an effect it
would have. It was very positive and so what we're doing now with House Bill 1505 is just lifting the sunset, bringing it back. We did make one change to the reporting on that, we took the reporting out because that was having an inhibiting effect on some participants with that, and that's really essentially it. That is the difference between last session. Bill and this one, as we're making it uh we're making it permanent now with me is uh uh John Wilkerson from the municipal League, and I think
this is a great story about how this bill came to be and just a little bit on the civic side of things. This is how ideas get worked out and and I think we've got a neat little story here, so if you don't mind, just share that if you
Speaker 230
1:10:41
would. Sure, so the at the Arkansas Municipal League, of course, we represent
Speaker 231
1:10:44
cities and cities and towns. I myself have represented police officers. For the better part of 20 years and so I'm well aware of the traumatic events that they suffer. I represented firefighters as well, and this the pictures that I've seen that they've seen live are just, um,
they, they don't leave me and I can't imagine being the person that actually saw it real time. So it's been an issue that we've been focused on for a long time. When Act 537 or House Bill 1302 was presented. We had some issues with it. We want to talk through it and work it out. And we ended up getting to a place where we, we could work it out with the sunset clause, as that was happening, the municipal League was working with Mr. Stallings over here. Other first responders, other people in the traumatic field and trying to figure out a way that we can do a number of things to help our first responders. One, get them the covers that they
need. Number 2, find the right people to provide that coverage and not and try and hopefully not make it cost prohibitive for a city to say, oh no, this is too expensive. We we we need to be careful with this, but we're trying to address all these issues at the same time, and we're working with Mr. Stallings in that group for a long time, and we developed what we call the TAP program, the trauma assistance program. Program. I get that I say program twice, but it's the tap program at the municipality where we identify counselors who can help first responders, we make sure the cities know that that that is out there for the,
for the first responder. Make sure that, make sure the first responder knows that the counseling is out there and make sure it's all confidential, which is not easy to do, but we've worked very hard to try to ensure confidentiality because we're very worried that without confidentiality, it's gonna be hard to get people to buy in, to get the help that they need. This is a long-term project for us to identify that counseling is a very important part of, of life, especially for first responders, and I can tell you, I, I train
LRPD 20 times a year. Um, every member of the LRPD gets the same uh training from me once a year, and at the end of each training, I say Act 537 was passed. Take advantage of those 12 mental health counseling visits because it is important for me as a citizen of Liter rock that you are there to protect us and you're good at it, but also we want to make sure that you go home happy and proud. what you're doing for the citizens of our city, and I think that's true for firefighters. It's true for sheriffs, deputies, it's true for all first responders, so we're very excited, we very much appreciate the working relationship with Representative
Wing and Mr. Stallings, among others, and this is, this is a terrific, um, this is just terrific for the state of Arkansas. Mr. Stalling, you got anything you want to?
Speaker 225
1:13:10
I'm going to try and be mindful of your time because I don't think I can say anything better than what they have. Uh, I'm here mainly for the experience side of the issue as a, as a firefighter and a peer support counselor. Um, and to just sort of reiterate what they've said. This is a tool that we can have in our tool kit to go and to be alongside things like peer
support, uh, but the idea here is, um, it's difficult to reduce the risk of exposure to trauma, but what we can do is, um, make sure that we have adequate access to the resources that we need both to stay healthy and to stay employed, and at the end of the day that's good for us as firefighters and it's also good for our employers and the communities that we serve. Happy to take any questions at this time? All right. Any
questions from the committee? Representative Pell continue I can ask for a question. Thank you, Chair.
Representative Aaron Pilkington
Unverified
1:13:58
Um, and you may have mentioned in your testimony and
I was trying to reread the bill to familiarize myself with it, but there's no fiscal cost with this, no financial impact at all. No effect to the state at all.
OK, great. Thank you. Any of the questions by the committee? See none, uh, Representative Wing, I do want to commend you on this as a mental health professional, I appreciate the work that you've done towards this, and this is a great step in the right direction for our state. We do have one person signed up to speak, uh, for the bill. Can, I can't read your last name.
OK. If you will, sit down at the end of the table, identify yourself for the record, and you will be recognized to present
Ken Slocum
Unverified
1:14:55
your testimony. So hit that button there. My name is Ken Slocum. Uh, I am
a part of a 501c3 called Heroes Behind the Lines. We provide Uh Counseling and support for all types of first responders, um, I was a police officer within Arkansas for well over 20 years. And uh Whenever I started police work, mental health was not only not thing, but it was very much discouraged. And
Uh I had this whole, whole thing about how I did a study, uh, on and statistics and all that stuff, and I'm not going to bore you with all that. Um, I'm just here uh just something moved me while I was sitting back there, um, I woke up at 4 o'clock this morning drenched in sweat. From All of the things that I have
seen throughout my entire life. As a police officer. Um, Whenever I started, like I said, it was. In fact, discouraged and a lot of times you would end up losing your career. If you talked about it. Um, we're finally making some headway in that it is acceptable to start talking about it and start dealing with things.
Uh, this bill is extremely important not only to first responders but to the overall community and the population of the state of Arkansas. That's it. Thank you for your testimony. Any questions for the witness? See Nunn, thank you for being here
Samantha Crocker
Unverified
1:16:47
today. Thank you for your service. Is there anyone else in the audience that would like
to speak for or against the bill. You recognize to come to the end of the table and identify yourself for the record.
Speaker 240
1:17:12
Hello, sir. My name is Gabriel Riviera,
Speaker 242
1:17:14
um, obviously I was not planning on speaking on this today, but uh. As a fireman as well, both professional and volunteer, uh, I absolutely do believe that this is something that We need to Have available for our guys out there, um, this, we have this stigma around talking about our feelings and. Obviously it's very hard for a lot of people to do. But
We need somebody that we can actually go out there and speak to. Um, because we don't, we don't want to feel bad for talking to our own guys. And saying, hey, I can't handle. This situation, I don't know how to handle it. Um, so That's all. I just wanted to give some comments on it as a both professional and volunteer firemen. I do believe that this is something that we absolutely need to implement. Thank you for being here. Any
questions for the witness? Sean, thank you for your
testimony. Thank you for your service. Anyone else in the audience that would like to speak for or against the bill.
Representative Carlton Wing
Unverified
1:18:25
See no Representative wing you're recognized to close for your bill. Thank you very much, Speaker, and I really want to commend everyone that has worked with Mr. Wilkinson, Mr. Stallings, Mr. Slocum, and many, many others. We've had monthly meetings with our first responders for about the last 4 years in which we have been talking about and detailing the needs of our first responders throughout the state. I'm very grateful for the work that they
do. I'm very grateful for the, the, the load that they shoulder every day in our community. They meet us during some of the worst times of our lives and uh and that there is a burden that comes with that, and this is a way that we can help them continue to be able to help us and you've heard this provides another avenue, a very necessary avenue for our first responders to get the help that they need. And with that, I'm closed for the bill and I would appreciate a good motion and a good vote. Representative
Ladyman has a motion to pass, as amended any discussion on the motion?
Seeing none, all those in favor say aye opposed. Congratulations Representative Wing. You've passed your bill. Representative Perrier, are you here and able to run House Bill 1682? If
you will identify yourself for the record and you are
Representative Chad Puryear
Unverified
1:19:50
recognized to present your bill. Representative Per your House District 25. I'm here with the Good Neighbor Act. It aims to address food insecurities by removing liability barriers to encourage more food donors. Um, it simply maintains our current protections while providing more descriptive definitions and adds clarity for a nonprofits and churches that are being donated food. Any questions by the committee? See Seeing that. Is there
Speaker 78
1:20:13
anyone in the audience that would like to?
So you know Representative Perrier, you recognize the close for your billing
Representative Chad Puryear
Unverified
1:20:29
we can do to encourage these good faith donors, I think it's gonna be a win for our communities and with that, I'd appreciate a good vote and happy to be a quick one
Speaker 30
1:20:37
today. Representative Bentley has a motion to pass any discussion on the motion. So none, all those in favor, say I opposed.
Congratulations, Representative Perry. You've passed your bill. Thank you, Chair. Thank you. Representative Mayberry. Are you still in the room? You reckon to go back to the end
of the table and we will pick up. Do you want to do house bill 1164 1st? Yeah. That quick. Are you wanting to do 1164
1st? Good job 1218. All right. If you will identify yourself for the record, ask your guests to identify themselves, and you will be, um, you'll be recognized to present
Speaker 249
1:21:29
House Bill 1218. State Representative Julie Mayberry. Marshall Dickey, um, certified therapeutic recreation specialists. My name
Katie Hall
Unverified
1:21:40
is Katie Hall. I'm a certified therapeutic recreation specialist working for Camp Aldersgate here in Little Rock. Commit, we have a handout to request
of Representative Mayberry. We're gonna hand that out. We're going to recognize you to go ahead and start presenting your bill. Well, I have to
Representative Julie Mayberry
Unverified
1:21:54
tell you I have been so impressed with our first
gentleman, Brian Sanders, as he has made it a priority to improve our parks around the state. We are the natural state and we want to make sure that people are getting outdoors and experiencing the beauty of our state, but there are some who struggle to experience the beauty of our state because of the inability to um actually access it. I started working with Shay Lewis and our secretary of our parks
department, there's been um quarterly meetings for the most part to make our state parks more accessible. We have seen some track chairs being added, one being added, I believe this week at Pinnacle Mountain that allows someone in um a wheelchair to get into this really robust industrial chair and, and get out and explore. It's, it's been great. Um, and we're seeing our cabins and our lodges improve with more accessibility um space wise,
allowing people to more freely move around in their wheelchairs and, and, and get around. It's been wonderful. Well, one of those, um, meetings that we had took us to Camp Aldersgate, and I don't know if you're familiar with Camp Baldur's Gate. I have been familiar with it for a long time. My daughter has spina bifida and has been a camper, many summer. in a row. She's now too old, um, but she would spend a week there with other children from around the state, experiencing canoeing
and um archery and all these other great sitting around the campfire. I, I mean even little things like that are just so wonderful and and getting to know other children with spina bifida from around the state. It's been a fabulous experience. So in one of my trips there, um, came across our of our recreational therapist and they said we need some help. And I said, how can I help you? Because you all do such amazing work and this is what they said they needed help with. So I'm
gonna let them explain what recreational therapy is and also why we need to license, um, recreational therapists in the state of Arkansas. I also want to point out, I have some others who are here to speak upon this bill. There is once a college in the state of Arkansas ATU that offers this as a degree and I don't think they got to sign the sheet, um, so I just wanna make sure that you're aware that I do have some others to speak on this
bill in just a minute. So go ahead, thank you,
Speaker 253
1:24:37
Representative Mayberry, and thank you committee. So recreational therapy, what is it? If you haven't heard of it or are not familiar, recreational therapy, also known as therapeutic recreation is a systematic process that utilizes recreation and activity-based interventions to, to meet the needs, the assessed needs of an individual with an illness or disabling condition that Promotes health, wellness, um, And quality of life overall
wellbeing. Um, these interventions, these recreational modalities could look like adaptive sports, swimming, hiking, fly fishing outdoors, um, Yes, but they're designed to meet the needs of our clients and Um We have currently 76 recreational therapists working in the state of Arkansas. In both clinical and community-based settings, those clinical settings include but are not limited to.
Inpatient and outpatient rehabilitation, mental and behavioral health settings, the veterans hospitals. And community-based settings, including Parks and recreation departments, of course, Camp Aldersgate, who serves children and young adults with disabilities in different medical conditions and a residential camp setting. So we are here today to pursue licensure for the therapeutic recreation profession. Um, services, rec therapy
services are rendered by a certified therapeutic recreation specialist. And a CTRS for short, and that is not to be confused with a recreation worker who facilitates activities primarily for enjoyment. There are currently 65 states who have achieved licener 6, if you include the District of Columbia and 13 other states pursuing licensure efforts, so we are, we are not the first, um, many more to come,
hopefully. But The importance of licener for us and for our constituents, our clients that we serve, there are currently over 8800, excuse me, 800,000 individuals with disabilities living in our great state of Arkansas. We work with at-risk populations, and so licensure, I think it's important to note that our certification, the CTRS certification is a voluntary certification. There are checks and balances at the national
level. Uh, I believe you have a handout in front of you a letter of support from the executive director of the National Council for Therapeutic Recreation Certification. Um As it is a voluntary certification without regulations at the state level, an individual could Drop their certification. If it is not required by the agency that they're working for. They could drop that certification, um, even if they have
Done wrong by their clients and could continue to work in the field at another agency, and there would be no, no records of that if they are not maintaining that national certification, so this would allow us to protect the Uh, the well-being of our clients that we serve and would promote high quality professionalism, the utmost level of professionalism for those working in within our scope of practice. Um
Speaker 259
1:28:15
So, like, um, like Katie said in Representative Mayberry was saying that uh describing a lot of adaptive recreation, but really therapeutic recreation is a modality of treatment that can be seen through a variety of venues, whether that's through the VA hospital here at Fort Roots in North Little Rock just right over the hill, um, as well as community based and then a lot of our colleagues are in behavioral health management thinking of those big mental hospitals around our state serving those youth with those diagnosis and needs, so There's a lot of opportunity for
care in this particular way, and like we described that licener is a really important way is just creating accountability for individuals in our state and making sure that the consumer and those clients that are are fellow Arkansans are being treated adequately. will take questions. Any questions by the committee? I
will start you out with a question so you and I had visited beforehand and, and I do have some concern about the creation of a lozenger, um, you
know, we have obviously as a state gone a different direction from that over the last couple of sessions, I think that we've tried to deregulate some of the the things where the Department of Health has some different lozenges and things like that can, can you speak to the importance of the creation of a license lozenger, are you prevented? Maybe this is for your, your witnesses, but are you prevented from doing anything now that this licener would allow you
to do or What what's the need for a creation of a lozenger?
Speaker 253
1:29:45
Sure, like I said, it really is to
protect the clients that we're serving, ensuring that those who are working within our scope of practice. Such as an activities director, um. is providing that high quality care for participants that they have the educational background and um professional knowledge and skills to deliver these services and are not going beyond that scope. Um Do you
Speaker 259
1:30:16
have something you like, therapeutic recreational
specialists, we use a very systematic approach in very intentional with our recreation and leisure interests, um, like giving those opportunities to our clientele, um, and so this way kind of creates um some accountability for that um and um as we, as we use that process, individuals who may be using recreation saying it has therapeutic value but not using it as a or claiming it might treat used as a treatment. modality but perhaps are not using it to its or staying or
working outside of their scope rather. Um, so this way kind of create some accountability for that, for individuals in our state, um, and to really Oh, yeah. Yes, well,
I appreciate that and thank you for your answer to follow up on that, you know, this may be something you want
to look at a registry. I know we've done a behavioral health analysis type, um, some lozenges or previous lozenges that we took and we took a registry type approach where we created a registry that was optional for folks, that way we could vet the
good actors, if you will, from the bad actors that may be a path that you want to look at as we move forward, but we'll open this up to the committee for questions.
Representative Julie Mayberry
Unverified
1:31:30
Any questions by the committee? Yes, ma'am. I'm sorry, if I can just kind of respond a little bit to that. I, you know. Right now, we license someone to do your fingernails and license someone to do your hair. These folks,
the recreational therapists are doing far more than that. And they are really getting to know their patients. They're
they're. Intimately involved in details of their life, their experiences, their health condition. And I think we want to put a hedge of protection around that. If we think there's value in making sure that your hairdresser has a license, then I think there's even more value in making sure that our recreational therapists who are with our most vulnerable populations in the state that
there's some code of ethics and that there's actually something that can be done, as you notice, there's some penalties in here. You know, we, we need to add these protections for the people that they're treating. And I'll leave
it there. Thank you for your response. Any questions
Katie Hall
Unverified
1:32:45
by the committee? Represented, I, I would like to add Representative Wooldridge, um. I
Speaker 253
1:32:50
understand there are some red some concerns about the red tape
that this might add, especially at the state level, I would like to, to point out, do, do not believe that this is in your documents, but one of the states that has achieved licensure that is North Carolina. They have Over 1000 practicing CTRS certified rec therapist in their state. They have also formed a committee to oversee licensure, the executive director of that committee is not only a professor there in North Carolina. Uh, she is also, she
works part time and is able to, to oversee this process as an as a part-time employee. Again, we only have 76 at this time, recreational therapists in the state of Arkansas, so we do believe that this would be a very very manageable endeavor. Thank you for your response.
Any other questions by the committee? Representative Graham like, you're recognized for a question. So I was just thinking about like
Speaker 9
1:33:48
this kind of stuff. So what if I already fill a position that a recreational therapist is in, but I'm so I'm doing that work, obviously I'm
Speaker 82
1:33:56
not licensed, but for whatever reason, would, would I lose my job or would I have to go get a license or
Speaker 253
1:34:06
how, how would something like that work? Does that make sense? That does make sense. That could be as simple as um educating the agency, the facility that they're working for, maybe reworking that job description. We don't want anyone acting as a recreational therapist who does not have those qualifications, um, just misrepresentation, so they would not have to fire the individual. We would educate the
organization. Sounds like it may. Be better suited for recreational therapist, um, so that might educate them on that as well, but there would be opportunities for them to definitely pursue education on that front, maybe a degree if the organization was willing to to fund that. Thank you. Any other questions by the committee? See
none. Uh, we don't have anyone signed to speak for or against, we do. I'm
Representative Julie Mayberry
Unverified
1:34:53
sorry. I, I said that they weren't able to
sign that's in the audience that would like to speak for
against the bill. You're recognized to come to
Tyler Rollins
Unverified
1:35:17
the end of the table and identify yourself for the record. Good Morning, everyone. My name is Tyler Rollins. Um, I am here really to, to be in support of my colleagues, um, and kind of explain the, the nature of
recreation therapy as a modality from a consumer perspective, uh, and also as a professional, I'm not a CTRS my um I'm a licensed associate counselor. I work for Chanel Family Therapy now. um. But I, my undergraduate degree is in recreation administration and I've done a lot of work for uh people with disabilities. um when I was 17 years old, I enlisted in the Arkansas National Guard, uh, and at 21, I was serving as a scout sniper team leader and during a
training event, I took a bad fall and shattered my C6 vertebrae and was paralyzed from the middle of my chest down, my hands were also paralyzed, um, I was as active a person as you can imagine. worked at a rock climbing gym, I'd backpacked, um, probably about 180 miles of Arkansas's natural trails. And uh an avid outdoorsman, hunting, fishing, all the things and then uh and literally the length of a breath, I was paralyzed and I was none of
those things anymore. Uh, so to speak to the level of professionalism it takes to be a certified therapeutic recreation specialists. It is much different, uh. A program director or a program coordinator, uh, is, is well below the scope of professionalism it takes to be a CTRS, um. So it, it would be like the difference between building bird houses and building purpose for someone's life, um, that is
absolutely the the difference that we're trying to um advocate for this hedge of protection around, not necessarily the practitioner, but the consumer to get the the appropriate level of service, um, I'll never forget Tom Horan when I broke my neck, uh, I went to a rehab facility in Denver called Craig Hospital. And I spent 3 months there and the most critical rehabilitation that I had was in the field of
recreation, um, because I woke up having my neck rebuilt thinking that I would spend the rest of my life in a bed and Tom, my CTRS, Quickly established that that was completely not true and uh starting my life over. Uh, began in Recreation therapy. Um, I know it seems Hard to kind of wrap your head around because the word recreation makes it sound fun. Recreation therapy was not fun for me. It was a training
session. And, and I took Tom's level of professionalism and the services he provided, um. Really Change the trajectory of what was possible for my new life, um, and now I'm as active as I want to be. uh, thanks to the theportunities that um people like my colleagues have uh been working toward and the opportunities they provide constantly. This is not something that is as simple as
helping people with disabilities to have fun and enjoy their life. It's helping people with disabilities to have a life and to build a lifestyle. I am, like I said, as active as I want to be, I hunt, I fish all independently, um. I've, I mean, my, my wife and I are, are building things all the time, um, I, I finished a master's degree in clinical mental health and, and it literally all started with the professionalism that Tom, my CTRS had at uh my rehab.
In the very early moments of this new, of this new life and uh I'm really proud of, of my, my colleagues for, for taking this initiative. They're not the first to the table, uh, there's a lot of success in bills like this in other states that they mentioned, um. And I, I think that it's I think it's critical that we Delineate the The scope of practice between what a program or activities director might be uh pursuing
with their, their clients and what um clinical professionalism it takes to be a CTRS. So, um, thank you for for letting me speak today. Um, I'm, I'm
Speaker 270
1:39:50
happy to answer any questions as well. Thank you for your testimony. Any questions by the committee? See no, thank you for
being here today. Is there anyone else in the audience, would you like to speak, ma'am? Are
you for or against the bill? I'm for, if you will identify yourself for the record in any organization
you may represent and you recognized to speak for the bill. OK, thank you for this
Speaker 272
1:40:14
opportunity to be here this afternoon. Um, I'm Doctor Kathy McMahan, um, certified therapeutic recreation specialist, um, I am the program director for therapeutic recreation program at Arkansas Tech University. Um, we are the only school in the state that offers a bachelor's of science in therapeutic recreation. Um, I have been there for a number of years, um, have a number of our grads go out into practice, um, the majority of those staying within the state of Arkansas, um, I think
the thing that we kind of have to keep in mind here as we're talking about this bill and, and this licensure is once again to ensure the safety of our consumers, um, a degree in therapeutic recreation is at the bachelor's level, um, there is a very prescriptive degree in which students are required to complete and then they. they're eligible or they they submit an application and become eligible to sit for the er the certified therapeutic recreation specialist, big word there, um,
um, to sit for that exam, once they have passed that exam, they have those CTRS credentials, um, we constantly, I think as as CTRS, as we have said, we may be small in number currently, but I think we're mighty in the outcomes that we provide, um, we provide very essential services, um, they, I think are and will be additional job opportunities, but I think the thing here is what we're really looking at once again is that level of protection and so I mean there is a very systematic approach to therapeutic
recreation, much similar to those in other allied health areas, um, but kind of to be honest with you, my concern is we do, we have a an awareness of other individuals who are out there practicing um as potential or using the term recreational therapist and I know they're not saying certified therapeutic recreation. specialists, but um I think that concern is once again making sure that we have individuals that are not only certified, but then licensed and that way we ensure ensure that we're
providing that level of safety um to those consumers that level of protection, um, and once again just I think that opportunity and like I said we are continuing and I'm sure that y'all are very well aware of this, but um they're a behavioral health facilities um continuously, um. Coming on board within our state, uh, right now probably looking at our graduates and if I was to survey, the majority of our graduates are working in behavioral health facilities, um, but also as we mentioned, I
mean, the veterans, um, the VA medical center here in North Little Rock is the largest employer of recreational therapist, um, in the nation. Um, we were very fortunate to have facility here in, in Arkansas, uh, but then also, um, our cities, um, city parks and recreation departments are employing um Certified therapeutic rec specialist. Um, there is that potential and, and that opportunity for the job market to continue to grow, um, I would love to see more students in our program because I'm constantly receiving calls, um, asking if we have grads, but I think
taking it to that next level for me is, is once again and, and to a certain extent protecting our profession, but more so protecting those consumers of of therapeutic recreation services. So I'd be happy to answer any questions. Thank you for your time today. Thank you for your testimony, committee.
Any questions? Say none, thank you both for coming and testifying today. Anyone else in the audience that would like to speak for
or against the bill. Seeing no Representative Mayberry, you're recognized to close for your bill.
Representative Julie Mayberry
Unverified
1:43:53
Thank you. You know, we've been looking a lot at
higher ed, and we want to make sure that we have return on investment, right? We have A program in the state of Arkansas producing recreational therapists, and they can meet another major need that we have in the state of Arkansas, and that's mental health. We know that that is a huge problem in the state, and we've been trying to find more people to provide those services. This is one other avenue, and I truly
believe that this type of therapy. Give someone, as you heard, their life back. And I'd appreciate a good vote. Thank you for your presentation. What's the will of
the committee? We have a motion to pass any discussion on the motion? See none. All those in favor say aye. All those opposed. Congratulations, you've passed your bill. Thank you very much. Without objection, committee, we're going to go a little bit out of order. We're going to pick back up at the
closer to the top of our agenda, Representative Johnson, are you reckon, are you prepared to present the amendment to SB 111. Yes sir, Mr. Chairman, thank you. Staff, if you
will, hand the amendment out, we'll give the committee a chance to review that and then you'll be
Representative Lee Johnson
Unverified
1:45:10
recognized to present. Members Representative Lee Johnson, uh, District 47. This amendment is the same amendment we've been putting on all of the compacts, amendment providing delegate delegatory authority to the ALC and the General Assembly, and I'd be happy to answer any questions on the amendment.
Mitty, any questions on the amendment? See, then we have a motion to adopt the amendment,
any discussion on the motion? All those in favor say aye, opposed. Congratulations, Representative Johnson, you are recognized to present Senate Bill 111 as amended
with the permission of the chair, I have someone here at the table. I'd like to introduce as well. If you will identify yourself for the record. Thank you, Mr. Chairman.
Speaker 276
1:45:57
Casey Casselberry here on behalf of the Association of Dental Support Organizations in favor of SB 111. Members, again, this is one of the compacts like many
Representative Lee Johnson
Unverified
1:46:07
we've looked at for different industries. This is supported by the dentist uh groups around the state and
I'm just going to turn it over for a further testimony to my guest here and take any
Speaker 276
1:46:21
questions after that testimony. Thank you, Doctor Johnson. I'll be very brief, uh, this, uh, compact was drafted with funding
Speaker 277
1:46:26
provided by the Department of Defense with one of the primary objectives being uh to help military families who relocate often who may have spouses that are either dentists or dental
hygienists in order to be uh uh licensed to practice in the states uh uh where they move uh it's similar to uh the bill that was presented earlier regarding physician assistants uh in that uh the dentist and dental hygienists will be subject to all the All the regulations of the state of Arkansas, uh, will be governed by the same regulatory bodies as any other uh dental practitioner in the state, uh, and we would ask that, uh, that you pass this bill and be happy to answer any questions that you may have. Any questions by the committee? See none. Is there anyone in the
audience that would like to speak for or against the bill. Seeing none and when no one signed up to testify, you're recognized to close for your bill. I'm close to my bill to make a motion to do pass as amended. That's a proper motion. Any discussion on the motion? See none all those in favor say aye, opposed. Congratulations your bill as amended. Representative Bentley, are you prepared to present Senate Bill 118? You reckoned us to go to the end of the table. It's my understanding you have a
handout. We'll ask staff to pass that out now. If you will have your guests identify themselves for the
Representative Mary Bentley
Unverified
1:47:46
record. Yes, sir. Thank you, Chairman, committee, thank you for presenting us bill Senate Bill 118 today and will, I will introduce my guest, Dr. Kelly Linton to put in. If you will identify yourself as well and
then you're recognized to present. Thank you, Mr. Chairman. Uh, my name
Kelly Linton
Unverified
1:48:01
is Kelly Linton and I'm a licensed audiologist in the state of Arkansas. My name is Doctor Kelly Linton, and I'm the founder and owner of
Center for Hearing and Balance for 27 years in Fort Smith, Arkansas, and Center for Industrial Adiometrics for 14 years, also in Fort Smith, Arkansas. I'm a lieutenant colonel, audiologist in the US Army Public Health Command. And I'm a professional supervising audiologist for the National Aeronautical Space Administration, or NASA. Attached to Kennedy Space Center, Artemis Rocket Project. The views I'm expressing today are mine and mine alone and do not represent those of the United States Army Department of Defense, nor do they represent NASA.
Thank you for the opportunity to speak in support of Senate Bill 118. This bill makes essential updates to the Arkansas Audiology Practice Act to better reflect the education, training, and expertise of audiologists while maintaining clear statutory limitations to ensure that audiologists practice within their scope of training. Audiologists are doctoral level healthcare professionals specializing in prevention, evaluation, diagnosis, treatment, and management of hearing and balance disorders. Today, audiologists entering clinical practice must earn a
Doctor of Audiology or AUD degree. UAMS offers an excellent AUD training program right here in Arkansas and requires 4 years of intensive post-specular training and roughly 2000 hours of supervised clinical experience. Among other things, audiologists receive formal training in medical diagnostics, including identifying conditions that warrant additional testing or referral to other specialists. One of the most misunderstood aspects of this bill is its provision allowing audiologists
to order diagnostic tests such as radiologic imaging, blood work, and cultures when medically necessary. I want to emphasize that audiologists do not perform these tests, nor do they financially benefit from ordering them. Senate Bill 118 is not about subverting appropriate referrals. It's about ensuring that patients get the right test at the right time, ensuring that healthcare provider to whom the referral is made can have the results of those tests in a timely in order to avoid delays
in diagnosis and treatment. Audiologists already conduct thorough patient evaluations, and when we suspect an underlying medical issue, whether it be a tumor, an infection. A toxic agent, a psychological disorder, or another condition, we refer appropriately. We simply need the ability to also order appropriate medically necessary test to optimize the patient journey and get them the help they need faster and with fewer unnecessary stops and costs along the way.
Currently, other healthcare providers with similar or in some cases less training than audiologists, including optometrists, chiropractors, physician assistants, and nurse practitioners are permitted to order diagnostic imaging and or blood tests and cultures in Arkansas. Audiologists should be similarly authorized to order these diagnostic tests so that we can better serve our patients. Another important component of this bill is clarifying that audiologists can perform cerumen or earwax and foreign body removal.
This is not a new or expanded practice. It is something audiologists already do safely and routinely in clinical settings. Types of foreign bodies commonly removed by audiologists include hearing aid domes or components, insects, and even jewelry. Audiologists are highly trained to remove these objects safely, often preventing unnecessary ER visits that increase costs and take up valuable emergency medical resources. Here, Senate Bill 118 simply
harmonizes Arkansas regulations with the Arkansas Audiology Practice Act. The same is true for health screenings. Audiologists participating in Medicare's merit-based incentive payment system already must perform certain health screenings such as smoking cessation, depression, and falls risk screenings to qualify for quality-based reimbursement. In Arkansas, medical students, nursing students, community health workers, pharmacy technicians and public health educators are frequently asked with performing.
tasked with performing health screenings in various settings. Consumers are also regularly encouraged to self-screen even for high risk concerns such as heart disease, stroke risk, and cancer. Audiologists are more than qualified as clinical doctoring professions to perform health screenings under the Arkansas Audiology Practice Act. Yet without this legislative clarification, patients may face unnecessary barriers to care. In summary, Senate Bill 118 is a common sense patient-centered measure that improves access to
ideological care, reduces unnecessary delays in cost and ensures that Arkansas law accurately reflects the education and training of audiologists. It does not expand scope beyond our education or expertise. It simply allows audiologists to fully utilize their skills for the benefit of their patients. I have dedicated most of my career to trying to help prevent hearing loss as an industrial audiologist in the military, civilian service and with our space program. Unfortunately we know that hearing and balance conditions
are actually on the rise and will continue as people are increasingly exposed to noise, autotoxic and vestibular toxic agents, viruses that cause hearing imbalance disorders and the deterioration of the auditory and vestibular system commonly associated with aging. Audiologists are more than critical than ever. Fortunately, we are also more than capable, competent, and qualified to care for these patients and to perform the services outlined in Senate Bill 118. I respectfully urge this
Speaker 282
1:53:57
committee to support and advance Senate Bill 118. Thank you.
Representative Mary Bentley
Unverified
1:54:03
Thank you. Thank you, Chairman. So I want to just kind of give some practical uh input for you guys to understand why we want to do this spill. So um I had my 90 year old mom stay with me for quite some time. She had hearing aids and she, my mom also had SVT, so she was on oxygen, so getting her to the doctor was just an all day task. And so what we're trying to do with this bill is to make it easier for our patients that have to be referred to an ENT to make sure the tests are done beforehand, so instead of me having to miss
two days of work to take my mom to the doctor, get more tests, and bring her back. We can just. have it with one trip, um. I think you guys can think about, I was thinking today, why, how can I practically describe this? When I go to the dentist annually, uh, the dentist is going to do a cancer screening on me, feel my neck and throat and looking for lumps or anything and I don't require the dentist to be an oncologist to do the health screening. We do health screenings all the time. We are, we are forty-eighth in the nation, and I think that anything we can do to increase and improve the amount of health screenings that we can do to make our patients safer, and I hope that you guys
will take a look at this heat map that we have up here. I think it's very important to see how many ideologists we have. across the state. We have a very, you know, very few ENTs. I think we have about 40 ENTs right now across the state and 249 audiologists. So what we're trying to do is get patient care, especially to rural Arkansas. To me, it's very important that we make sure that our patients are taken care of as much as possible. This bill really is a cleanup language for things that they are already doing and just really make sure that our patients get the best care possible, especially in rural Arkansas. And so with that I would be happy to take some
Representative R. Scott Richardson
Unverified
1:55:29
questions from committee members. Representative Richardson, you're recognized for a question. Thank you, Mr. Chair and thank you Representative
Bentley. Uh, I had a, actually I had a question for the person with you. You're, you're located in Fort Smith. I'm a little familiar with Fort Smith. Where are
Senator Jane English
Unverified
1:55:48
you in Fort Smith? We're on 74th Street. OK, South
Representative R. Scott Richardson
Unverified
1:55:50
74 74th Street across from the hospital. So if you could walk me through what's the current process that has to happen when, if I came in to visit you to get my check because you're, you're asking to
to be able to request these tests or walk me through what happens today.
Kelly Linton
Unverified
1:56:05
Yes, absolutely. So if you came in for an exam and say that you were having some unilateral hearing loss and not sure what was happening, you would come in, you would schedule for a hearing test, um, very likely your primary care physician might have referred you, um, it's difficult. get into ENT, so it's usually not the first stop, maybe primary care sent you in. So we do a battery of tests and determine that it's not just your standard run of the mill hearing loss that you may have something else going on, possibly a tumor, maybe an infection in that ear, depending
on what our tests indicate. The next step that we would like to be able to do is to be able to order that imaging. What happens now is we can, we basically we tell you you need to go see ENT to get a medical clearance and then the wait for medical ENT visit is, um. Depends on the area. It can be several weeks to many months, and the ENT is going to look at our test results and say, You probably need an MRI. Maybe you need a blood culture or some type of a culture, and then they're going to order those
tests and send you back home to wait, then you're gonna come back and get into ENT again. All we want to be able to do is to preliminarily order those tests so that when you show up at ENT, the tests are done and it's just one visit, then the ENT or specialist, I'm saying using ENT because of the example that I gave, but it may be back to your primary care or back to the nurse practitioner, whoever referred you to us, uh, you would already have those. that would indicate what the situation was. An actual example of a patient that I dealt with
is one that had drainage and actually a perforation or a hole in his eardrum where it drained continually. Now I wore hearing aids, so my problem was trying to fit hearing aids and keep the hearing aids working with this continual drainage in the ear was very difficult because it would cause the hearing aids to break down. And I would send him back to ENT and the local ENT would quickly suction the ear out and say, come back in 3. months. Well, this went on and on for years, multiple years, um. The patient basically begged me to find someplace else to go
because he didn't want to go every 3 months to have this ear suction with this just drainage happening. And of course he'd been on every kind of antibiotic, every type of medication, so I called around and found an ENT in Little Rock, which is about 2.5 hours a drive for us and ask the patient if he was willing to see this person that I spoke to, because I was suspicious, something else was happening. I don't have any tests, but I'm suspicious. Um, and he said, yes, well, in the 1st 30 minutes of UAMS. Do the culture on this person, they determined it was a
cerebral spinal fluid leak, um, that was going to continue for the rest of his life until they went in and did surgery and repaired the tympanic recess and repaired the leak. Uh, and it was solved. It was solved. It was, you know, it was taken care of with the surgery. Once we identified what was actually happening in the ear. And so it just, it helps us cut down on those repeat appointments. It helps us partner with the specialist, and that's, that's the key thing we want to partner with them so that they have the test accessible that they need to
Representative R. Scott Richardson
Unverified
1:59:04
make their diagnosis more efficiently. Follow up. So how often when a person comes to you, how often? Are those tests normally requested from, not from you because you can't do that right now, right? So when you send them to an ENT or back to the primary, do they normally request a test at that point? Yes, typically they will.
Kelly Linton
Unverified
1:59:30
We, we know different, different doctors practice differently. So, you know, if we're suspicious of a particular type
of a condition, we might send it to a doctor that we know is gonna order a scan more efficiently. You know, some are like the auntie I described where they just kind of um address it in the office only and don't seek
Representative R. Scott Richardson
Unverified
1:59:48
other testing, so this isn't giving you any additional medical privileges, it's just allowing you to say, hey, we need this test done to, to give to
the ENT or to the primary, right? We do
Senator Jane English
Unverified
1:59:58
not want to read the test. We don't want to perform the test. We don't want to be reimbursed for the test. I
don't want to own the equipment to do the test you, thank you, thank
Representative Kenneth B. Ferguson
Unverified
2:00:13
you very much. Representative Ferguson, do you have a question? Yes, yes, just a quick question. Now, you already have the authority to remove certain uh What, what do y'all call it certain foreign objects foreign objects and uh. Uh, wax. Yes, sir. OK, is an instrument used in that regard? Well, it depends on the audiologist's comfort skill
Senator Jane English
Unverified
2:00:37
level and how they've been trained. I will tell
Kelly Linton
Unverified
2:00:40
you at our clinic, our first go to is irrigation. We're gonna use a warm water wash to flush out anything that's in there, and the only instrumentation that we'll typically use is if the wax or the foreign object has lodged itself right in the corner and we'll use a curate to remove that. is
Representative Kenneth B. Ferguson
Unverified
2:00:55
a curate like a pronouncing this correctly, a Jobs and horn. It has a hook on it.
Speaker 300
2:01:04
Not familiar with that, but it's, it's just a little round
Representative Kenneth B. Ferguson
Unverified
2:01:08
with an eye in the middle of it. OK, maybe that's what it is, I have a, uh, a wax build up in my right ear, about once a year, and I go to a ear, nose and throat specialist. He takes a little horn, a little something with a little
horn on it, a little round to remove the earwax out of it, OK. All right, yeah, it probably is, and I will tell you what the curettes
Kelly Linton
Unverified
2:01:30
that we use are much safer than anything that you're gonna. to purchase over the TV that they are now advertising and selling, so please don't do
that. OK, thank you. Thank you, Mr. Chair. Yes, sir. Any other questions by the
Speaker 309
2:01:45
committee, Kendra Moore, you're recognized for a question. Thank you, Mr. Chair. So, and Representative Richardson may have answered this. With his question, but this bill just expands the scope. To diagnose these medical conditions versus an ENT. Is that what you're trying to, no,
Speaker 310
2:02:02
ma'am, we are not diagnosing anything, uh, and we are not expanding. We are asking to be
Kelly Linton
Unverified
2:02:09
able to order the test so that the specialists can do the proper diagnosis more efficiently, so
Speaker 311
2:02:14
it's a it's a Versus a referral. Is that what you're trying to correct,
Kelly Linton
Unverified
2:02:20
I believe so, yeah, we, we do not want to diagnose. The results will not come back to us. So if we refer someone on for imaging, that test will be done so that they can take those to the specialist that they're going to be seeing for a proper efficient diagnosis. So overall, this is just trying
Speaker 309
2:02:41
to save the patient time. Yes. Is it also saving the system. Money through Medicaid or yes, most definitely, because
Kelly Linton
Unverified
2:02:48
it's just another referral, it's another PCP appointment or specialist appointment, then they go get their test, then they come back for another specialist or PCP appointment. Do we know if DHS has an opinion. I do
Speaker 314
2:03:00
not on this bill. I've not heard anything negative at all from DHS
Representative Mary Bentley
Unverified
2:03:05
or they're neutral as far as I know. Representative Moore, are you
requesting them to come to the table or are
you just asking that of the sponsor? OK, thank you for your question.
Representative Lee Johnson
Unverified
2:03:22
Representative Johnson, you're recognized for a question. Thank you. And in my apologies for not getting with you earlier, uh Representative Bentley. There's a couple of questions here I have just logistics. I think mostly I'm supportive of what you're trying to do here. I there it says uh that you would order cultures and blood testing. That that's a pretty broad um,
Opportunity, um, when you, when you say cultures, do you have a specific type of culture that you would order and when you say blood testing, do you have specific types of blood testing that are typical that you would look to order because that's a pretty, you know, there's a lot of things that you might not necessarily want to be able to order as an audiologist, whether it's, you know, hemoglobin A1C or uh cholesterol or you might say, well, of course I wouldn't order that, but as it's written, it's pretty open. um, what are the kinds of blood
tests and cultures that you're looking to try to order and is there a way possibly to clarify that sum.
Speaker 296
2:04:24
Yes, uh, the, the blood cultures and um workups that
Kelly Linton
Unverified
2:04:27
we would be interested in are those that are relative only to the vestibular system, and the hearing system. Those typically are vitamin D. It's a very large one. We know a vitamin D deficiency is very prone to vestibular issues, and that's almost a regular one that audiologists that already have this capability, that's a regular one that they look at
with vestibular issues. Cultures could possibly be drainage in the ear, unidentified drainage. Is it cerebrospinal
Speaker 312
2:04:52
flu? it or is it just infection? Is it just goop, whatever it is. I could
Representative Lee Johnson
Unverified
2:04:59
have follow up, uh, so again you see in the bill my concern about the wording of the bill is that that's pretty open, and I, I don't see how it would preclude you from or any audiologist from ordering any blood tests. They wanted to if a family member or friend or hey, I'm having trouble getting into
my primary care doctor to get my fill in the blank. Checked. I mean, it feels like there's probably some way to arrange that language in a tighter space that would clarify specifically what might be appropriate for an audiologist versus others. Do you agree that language is a little
Kelly Linton
Unverified
2:05:35
open, you know, in that situation, I would hope that as a doctoring profession we are staying within our lane. Um, I mean,
Speaker 310
2:05:42
don't other doctors, I mean, aren't they typically held to ordering tests that are only relevant to what they're needing, um, be
able to just justify the need for what they've ordered. I mean,
Representative Lee Johnson
Unverified
2:05:52
I guess the difference is that physicians are trained as our APRNs and PAs in a broad scope of medicine as opposed to audiologists or you know, in a pretty narrow field. If I could follow up with another question. I'm, I'm wanting to understand that
Representative Mary Bentley
Unverified
2:06:07
for sure so I just think looking at the bill um because it's under audiology, so to me it was very specific under audiologists and what they're trained to just like we do like with nurse practitioners, they're very narrow and the scope that they practiced in to
me were very narrow. in the audiology department. So I think listing it under audiology, it's going to be something based on that, so I guess that's what gives me comfort on
Representative Lee Johnson
Unverified
2:06:29
that listing there, so thank you. That's helpful. And then just if you could walk me through again how who would interpret the results because I do have something a little bit of anxiety around um how, how that would be interpreted. I mean, the, the radiology films that's pretty straightforward a radiologist going to receive those going to interpret those. The blood testing, if some
things ordered. Are you Going to interpret those results, and if not, how would, what's the process that you would anticipate to to have those results. My anticipation is that the
Kelly Linton
Unverified
2:06:59
test result would be would be coming would probably come back to us as the ordering person, and then we would refer them on to their PCP, like if there was a vitamin D deficiency, um,
Speaker 310
2:07:09
refer them to their PCP for remediation of that or concern of that. Any other questions by the committee?
See none. We have several folks that are signed up to speak for and against
the bill. We'll start with 4. we have Stephanie with the Academy of Doctors of Audiology. If you will come
to the end of the table, identify yourself for the record and who you represent, you'll be recognized to testify. Thank you. My name
Speaker 321
2:07:41
is Stephanie Chayesky, and I'm representing the Academy of Doctors of Audiology. You're recognized. Thank you. I serve as the executive director
of the Academy of Doctors of Audiology, which represents audiologists and audiology students. In Arkansas and across the country. I thank you for the opportunity to provide testimony to you today in support of SB 118 to make important and necessary updates to Arkansas's audiology Practice Act. The proposed legislation takes the conservative approach to modernizing ideology's statute here in Arkansas.
And it, it works to conform it to contemporary clinical practices, national standards, and federal and state regulations that already exist. In addition to the examples highlighted by Dr. Linton in her testimony, SB 118 aligns Arkansas statutes with the US Food and Drug Administration regulations for the newly established prescription hearing aid category. Further, it will also make technical amendments to Arkansas statutes to bring them in line with national standards of
practice and recognize clinical practice guidelines. Finally, the requested changes are supported by the Education and training that doctors of audiology received during their doctoral training programs such as the one at UAMS. Arkansas faces a growing shortage of healthcare providers, primary care physicians, nurses, and specialists are stretched thin, especially in rural areas. Updating the audiology Practice Act will alleviate pressure on the broader healthcare system by
ensuring that audiologists can provide services that they are already trained and licensed to deliver. Importantly, SB 118 ensures that Arkansans, particularly those in rural and underserved communities have better access to timely and. effective hearing and balanced care. As as Representative Bentley pointed out, you have a handout that clearly demonstrates that in many parts of the state with the geographic distribution, uh, of audiologists and otolaryngologists that many,
many citizens of the state rely exclusively on audiologists for primary hearing and balance health care. SB 118 will help ensure that audiologists can practice to the full extent of their education and training, allowing them to provide the essential services Arkansans need and also authorizing them to order medically necessary diagnostic tests. This provision will not undermine referrals to other specialists. In fact, when it's medically necessary, it will simply reduce the time for
patients to get the treatment that they need from those other specialists and professionals. SB 118 maintains the appropriate guardrails while codifying audiologist's role in evaluating, diagnosing, managing, and treating auditory and vestibular conditions. It offers a pragmatic patient centered approach that ensures the timely delivery of safe, effective, and evidence-based hearing and balanced care for the citizens of Arkansas. For this reason, I urge you to vote
in support of SB 118. I would also like to point out that when looking at the way that the legislation was drafted. Other, uh, similarly trained clinical professions. acts were also evaluated. So if you look at the way that the language is worded for the proposed bill for audiology, it is, it is constructed very similarly, for example, to the way the bill for optometry is constructed the way it bills for other professions are
constructed so that it really harmonizes the way that these clinical doctoring professionals are treated within state law. And when you look at what some of these other clinical doctoring professions, uh, are doing. in terms of services within their scope of practice, I think it's very easy to see how very conservative this approach really is. Um, when you look a little bit higher up into the into the legislative text,
they're very, uh, frequent references to auditory and vestibular. There's no question but that the services performed within this act will be performed by audiologists in a way that, that is really consistent with what their scope of practice is and confined to the audio, auditory and vestibular systems within the year. Thank you for your consideration. Thank you for your testimony. Any questions by the committee? See Nun, thank you for
being here today. We're going to move
to against Dr. Lance Manning sign to speak against the bill. If you will identify yourself for the record, and you will be recognized to
Speaker 326
2:12:45
speak against the bill. Good Morning, Doctor Lance May. I'm the chair of physician policy for the American Academy of Angiology head and neck Surgery, which is a Long way of saying ENT. Um, Chair Wooldridge, members of the committee, I appreciate your time this morning. I've had several professional roles in my career as a physician, both with
our Academy nationally and the chair of the board of governors, etc. chair of Northwest Health, uh, system, but chief of staff, but first and foremost has been as an ear, nose and throat physician and surgeon here in Arkansas, uh for the past several decades in a clinic setting as well as at both the private and nonprofit hospitals in Northwest Arkansas, including Arkansas Children's Northwest. I'm very familiar with the practice of Medicine, audiology, and, and otolaryngology specifically across our state and across our country. Um, I'm actually a graduate of Bentonville High
School back when it was a little bitty town, which it is no more, um. So personally since returning, To my home in Northwest Arkansas to raise my family and help care for our community following 4 years down here at UMS and then 5 years at Mayo Clinic. Uh, I've employed multiple audiologists, um, um very familiar with their training, their expertise, and I've worked shoulder to shoulder with them for 20 years, and frankly, I appreciate the work that they have done and do for our clinics and for our patients and both hearing testing and
balance testing, um, I've enjoyed supervising them and in fact, the audiist that testified for the Arkansas State Senate was one that worked for me for many years, um, I wanna get to the heart of this bill and address some specific issues that have been presented in discussions both here and in the Senate. I think the bill, as you've heard, can really be broken down into two parts. There's the part regarding cleaning of er and wax from the ears, removing foreign bodies such as tips of hearing aids. I totally agree. That's within the
scope of practice, as well as within the training of audiologists both in the state and elsewhere. But I think the second part of this bill is the part that is really the most important and there's been discussion that this has been within the training as well as the experience of audiologists to order blood cultures, you know, laboratory testing and panels, non-radiographic scans and radiographic imaging. This bill is not just about the definition of audiologists saying that they've been trained to clean earwax.
My testimony today pertains particularly to this large and important second part of the bill. This bill has been called a modernization of the definition of audiology practice standards. I think it's actually just frankly, an expansion of practice. The definition of audiology as proposed in the Senate Bill 118 includes a broad expansion of services that they may perform and currently do not perform, including the evaluation diagnosis and management terminology that typically refers to the practice of
medicine. When these terms are used in other health professions are typically limited or qualified uh by a requirement for higher education and training within that specialty and this type of training for audiologists. in our state and elsewhere in the country has just not occurred. The curriculum of their training is not comprehensive as it is with some of these other health professionals that have been discussed and when compared to medical school and years of residency is inadequate to diagnose complex medical conditions.
Potentially missing neurological conditions, tumors, complex autoimmune diseases. Which I can personally attest as the reason that I got into this specialty and into this profession, my grandmother, uh, was postlingually deaf from a complex autoimmune hearing loss and a personal experience as well as professional experience with these, um. I can say there's only one state in the country, Maryland, that has a law allowing audiologist to order lab work, blood cultures, no radiographic
testing, radiographic images, and that law was codified October 1st, 2024. OK. That being the case, there's no way that audiologists have been trained to do these things or any experience. There's only one state and only for 5 months that they've been allowed to do it. Where has this experience come from? These things have been stated that's within their scope of practice. I don't think there's a single audiologist in Arkansas that has ever ordered a single one of these tests. If you think about what it takes
to order a test, we'll go back before the days of electronic medical record, when, when most of us would go get a lab test, we'd go get X-rays, MRIs, etc. What would happen? You'd go and see the doctor and they would take, and they'd write on the prescription pad frequently. They'd write at the top, and you have to, you have the name, date of birth, date of the test that you're requesting, you'd write the diagnosis. You absolutely have to write a diagnosis on there's a, there's a list called ICD 10 list, and if people, if you've never written for medical tests. You may not know
that, but the ICD 10 list has a list of diagnoses and these lists of diagnoses, they have to be appropriate for one, the insurance company to pay for the test you're getting, and you've all experienced this. If the wrong test is written on there, then you're not getting the test. And then that is taken and it's received at a hospital or imaging center or lab, and it, it will take and and they'll order and there's a list that the lab tech has of these appropriate diagnoses which are made in advance if you order the test. It says, yeah, these tests are appropriate.
If There's only been one state. There's Allow this to happen and only for 5 months and where's all this experience and training taking place. It certainly hasn't occurred. Everyone here has not been trained in Maryland, and that in training in the last 5 months. So I would say that the experience and the training have not taken place to do that, and we're not talking about ordering necessarily simple tests, though some might be. But to diagnose some of the very complex medical problems that present with some balance in hearing disorders, you have
to have a broad knowledge of autoimmune problems, neurological problems, tumors, and, and. That is something that if you don't, it doesn't speed up access to care. What it does is it actually delays diagnosis when you don't get the right tests ordered. causes unnecessary expense when you order the wrong test with the wrong diagnosis. And then, and then lastly, what it does is, if you put the wrong diagnosis on a patient's chart, patient's order, and we're not talking about necessarily in the days of and that paper scripts
for orders goes in electronic medical record with the wrong diagnosis. Guess what? That's one. Your record, that's on the record of your family. Or your constituents or their families, and nobody wants that. Um I'm gonna Say that, you know, while part of this bill, I think is very appropriate and defining some of these things such as cleaning of the room and removing some foreign bodies, which just makes sense. Making sure that we have the right people in the right place, ordering the right test with the right diagnosis is critical to our healthcare
system and While the citizens and access issue. Yeah, there's, there's possibly fewer ENTs and audiologists in the state, but most of the time the tests that are getting ordered before they referred to me or what happens is the primary care doctor, who there are many of in the state and certainly many in rural environments, they'll call and they'll say, hey, I've got this patient with X. You know, what, what would you like me to order? I get these calls multiple times a day. And I'll say, OK, well this problem we're going to order a CT scan
and we're going to order an MRI. We're going to order a Doppler ultrasounds. We're gonna, uh, order this panel autoimmune panel, or we're going to order this panel for neurological tests, and then we'll establish that care, so I don't think this increases access because I think the importance of getting the right diagnosis in the first place. And the right test being ordered in order to not cause more expense and to not cause a delay in care, uh, it is paramount. I want to close by saying that I totally agree there's a time and
place for different providers in healthcare in Arkansas. I'm very appreciative actually of the work that our audiology colleagues do. I think that they do a good job testing. Counseling with regards to hearing and balance disorders. I just simply think that this bill does not put audiologists in the correct place.
Speaker 327
2:21:05
Thank you for your testimony. Any questions by the committee? See
Nunn, thank you for being here today. Next, we have Blair
Samantha Crocker
Unverified
2:21:17
Casi signed up to speak for. The bill If you will identify
Speaker 329
2:21:30
yourself for the record in any organization you represent and you're recognized to testify. Casey Casey. Thank you, members of the committee for allowing me to be here today. My name is Blair Casey, like I said, and I'm a 2nd year doctor of audiology student at the University of Arkansas for Medical Sciences. Um, I first would like to state that these opinions are of my
own and they are not associated with UAMS in any way. I chose to pursue this path because I've always been driven by a desire to help people regain their connection to the world around them. Auditorium vestibular health are essential for my, for overall health, wellbeing, and quality of life, and I intend to dedicate my career to making a meaningful impact in these areas becoming a doctor of audiology student isn't easy. It requires
a 4-year undergraduate degree and a four-year clinical doctorate degree. Extensive clinical training and also a significant financial investment. My classmates and I are learning to evaluate, diagnose, manage, and treat hearing and balance disorders using advanced technologies and evidence-based practices from conducting health screenings, diagnosing and managing tinnitus, hearing a vestibular conditions to
performing non-radiographic imaging and removing foreign bodies from the air our training is as comprehensive and challenging as I of. Other Clinical doctoring professions. We are also trained and prepared to recognize when additional medical care is needed and to refer patients appropriately. SB 118 is incredibly important to me because it recognizes the education training and hard work. I am my classmates have
invested to become clinical doctoring professionals. We chose this profession to help our patients and we believe that audiology should be recognized under the law in a manner that reflects our extensive education and training. This legislation will ensure that we can apply the skills we have acquired in school to provide timely, effective and affordable care to the people of Arkansas without unnecessary barriers. I plan to stay in
Arkansas after I graduate, but only if I am able to practice to the top of my training. Anything less will be a disservice to me and my patients. I urge you to support SB 118 and help future audiologists like me serve the community with the expertise we have worked so hard to gain. Thank you for your time and consideration. Casey.
We take questions from the committee.
Representative R. Scott Richardson
Unverified
2:24:17
Representative Richardson, you're recognized for a question. Thank you so much for your testimony. My question is audiologists, in
order to be an audiologist, you have to have a doctorate, or is it, can you be
Speaker 329
2:24:31
an audiologist with the undergrad degree. You have to go to for of undergrad and get a bachelor's degree and then you're required to get a doctorate from an accredited university,
Representative R. Scott Richardson
Unverified
2:24:41
so you can't work inside of a facility without the doctorate. I'm not sure about
Speaker 329
2:24:47
that. OK, thank you. Any other questions from
the committee? See you then, thank you for your
testimony. Thank you. Next we have to speak for the bill, Kelly Linton. OK.
Next up we have Mary. Chatlane Is that close? You will identify yourself for the record and any organization you represent, you're recognized to testify. All right, can y'all
Speaker 191
2:25:19
hear me? You did good with the pronunciation. I messed up Casey, so most people don't get it right.
Speaker 336
2:25:28
Well, um, I'm Doctor Mary Chatelaine and I'm here to represent the Arkansas Academy of Audiology. My name is Doctor Chatelaine, and I'm here before you as a licensed audiologist, President-elect of the Arkansas Academy of Audiology and owner of Pinnacle Hearing with offices in Little Rock and rural Camden, Arkansas. I have also been honored to serve on the Arkansas Board of Examiners in speech language pathology and audiology following my appointment by Governor Sarah Sanders.
While the views I expressed today are my own and not those of the licensing board nonetheless that experience has helped me inform my opinion and I thank you for the opportunity to testify today. I'm here today to express my and Ara's enthusiastic support for SB 118. Critical legislation designed to modernize Arkansas's audiology scope of practice. I've seen firsthand the impact limited healthcare access has on rural communities. I grew up in Magnolia, a rural
community in South Arkansas. My grandparents lived in the small town of Stevens and in Camden. I remember my mother having to take full weekdays off to travel, to drive my grandmother to medical appointments, sometimes in Shreveport, sometimes in Little Rock, due to the lack of healthcare services in South Arkansas. In fact, it was the memory of my grandparents and others from small towns who needed but often lacked access to essential audiological care that inspired me to expand my practice to this rural area.
In 2015, the CEO of Wachita County Medical Center approached me deeply concerned about the lack of audiology services available to residents in South Arkansas. When Miss Abbott first approached me about expanding my services to rural Arkansas, I hesitated due to the logistical challenges such as travel, time, and mileage. Then I took a step back. And I realized that this was exactly the kind of care that my grandmother's needed and couldn't get in their home. I thought about the many people I know who lacked access to
quality audiological services and that made it an easy decision. Today my practice proudly offers consistent local audiology services in rural South Arkansas. Significantly improving health care access and reducing the burden on patients who have previously traveled great distance for hearing healthcare. Over the past decade, we have served countless patients who are incredibly grateful they no longer have to miss an entire work day to travel to areas like Shreveport or Little Rock for care.
Modernizing Arkansas's audiology Practice Act will further improve access to hearing a balanced healthcare, especially in our rural communities. As an audiologist, I believe the additions to this scope of practice outlined in the bill coincide with my training and we'll improve patient care in both Central and South Arkansas. SB 118 represents a sensible update to Arkansas statutes, allowing audiology's practice with comparable healthcare professions already permitted. To perform similar tasks such as ordering blood work and
diagnostic imaging. By allowing audiologists to order these tests, patients can get the right diagnosis faster, avoid unnecessary referrals and receive better care without delays. This would improve treatment outcomes and make health care more efficient for everyone. With this bill, my colleagues and I are not asking for anything that would give us any type of financial gain. We are simply asking to be allowed to serve our patients in a way that provides them with the most comprehensive testing and a clear understanding of their health. This ensures that when we refer
them to the specialist, these specialists are armed with the knowledge they need to make an accurate diagnosis and treatment plans in a timely manner. Passing SB 118 means quicker intervention for hearing and balance disorders and more equitable healthcare for all our Kansans. It represents a meaningful enhancement ensuring audiologists can utilize their full scope of training and expertise to benefit Arkansas. Thank you again for your consideration. I respectfully urge you to pass SB 118, and I'm
available to answer any questions you might have. Thank you for your testimony. Any questions by the committee? Say no, thank you for being here today. That's all we have signed up. Is there anyone else
in the audience that would like to speak for or against the bill? See known Representative Bentley, you're recognized to close for your bill. Uh Thank you, Chairman.
Representative Mary Bentley
Unverified
2:30:03
Thank you committee and uh Represent Richard, just to be sure, they have to get their doctorate, have to have a doctor
to build a practice in there again, this is all about patient care, uh, and patient access, I think is a great bill in order for our patients to be seen, uh, to get the care they need in rural Arkansas and get to save time and to save money and to save us having to get an extra day off work to take a patient to another visit. So to me it's all about access to rural care. I understand uh Doctor Johnson's concerns about that, but under there I believe it's under audiology, so, um, and it was passed the Senate, well, I'm just not sure that we really need to amend the bill. at this point, but I will, um, at this point, uh,
I really like motion do pass on this bill, and I think under being, because it's under ideology, it's under themuting cultures and that if you read the whole bill in its entirety, um, I think that really covers what we need to cover here. I'm not trying to open up uh Some of the old blood cultures is to order blood cultures. One, there to be specific specifically under distributor and uh hearing loss, sorry, stibular anyway, ENT is a tongue tier. So anyway, with that, uh, I would make a motion do pass on the bill. That's motion on the motion
Representative Johnson, you're recognized for discussion on the
Representative Lee Johnson
Unverified
2:31:14
motion. I understand what you're saying. I, I would, I would feel more comfortable if the bill was amended to reflect more like the language that I'm seeing in the Maryland bill, um. It's so it's hard for me to vote for this bill based on that, those those one caveats that just you and me interpreting that differently. I feel like it does open that up, um, and if that could be amended, I think I could be more comfortable with it, um, and again, it's clarification. I'm no lawyer,
it's just the way I read it, I have concerns that it opens it up in those spaces and that gives me some reason to pause on on the issue again, most of this bill, I think I fully support. and and even with some guarddos up I could support some of the things you're asking. It's just I'm concerned those guardrails don't exist in the current language.
Representative McGee, you're recognized for discussion on the motion.
Representative Richard McGrew
Unverified
2:32:08
Thank you, Mr. Chair. I can, I concur with what, with uh
Representative Johnson said, but, you know, To me it's pretty vague. Um I'm as a physician, I'm thinking, why do you order a test? You know, we make a diagnosis and that's how we base our tests. We don't make a diagnosis based on what the test is. That's one of the things you learn in medical school. You, you go through a whole differential of things that may be occurring, and then you order appropriate tests to, to determine if that's the direction you need to go and help me change your mind and may
change your diagnosis, but But just having a broad statement that says we can order and order these tests. I don't see that that increases access to care. I think that potentially could delay care. Um, one state has passed a similar bill which was more restrictive than this one, and it was just recently passed. I don't think Arkansas ought to be #2, so I'll be a no vote on this. Thank you. Representative Pilkington, you're recognized
Speaker 227
2:33:08
for discussion on the motion. Now that the doctors have made comments and administrator will
Representative Aaron Pilkington
Unverified
2:33:15
make a comment, uh, no, I mean, I think I understand we pass fake bills here all the time. We're able to address those issues and rules, and I think those guard rails we can, we can put on later, so I, I've got no issue doing this, uh, the fact Marilyn's the only other state, uh, this does not give me pause, I think, you know, when you look at this map and we see the lack of providers we have, I think um. I, I think we just need to get more aggressive and do this, so, you know, we have ALC in the interim for a reason, and we
have a Department of Health and humans and we have DHS and so I'm, I'm more than capable that we can pass this bill so that we can implement this in a way that protects our patients, uh, but ultimately I just, you know, getting more care and more patience is the most important thing, and we're supposed to do no harm and so I don't see the harm in this bill, so I'd appreciate a good vote on this. I make one
Representative Mary Bentley
Unverified
2:34:07
more comment, Chairman, just quickly on the motion you're. We are forty-eighth of the nation in health, and at some point we're gonna have to do some things different to improve
the health of our Kansans. That's really the reason I bring this bill. I think it's a great bill to improve our patients' health and our patients' care, so I think we do have it's under audiology I think and um as Representative Pilkington said in rules we're going to make sure that this is exactly what Dr. Johnson wants to address. So with that, again, I will be due pass. Any other discussion
on the motion? See none all those in favor, say I opposed? Nose habit. Thank you, Representative Kavanaugh, are you still in the
room to run House Bill 1275. Committee members hang with us. We've had two folks waiting a long time. We're going to hear Representative Kavanaugh's bill. Representative Mayberry's bill, and then we'll be done for the day. If you will identify yourself for the record and you are recognized. To present House Bill 1275, uh, Fran
Representative Frances Cavenaugh
Unverified
2:35:08
Kavanaugh, state rep District 30. There is a fiscal impact with this.
We're going to have staff hand that out to you now and we'll be reviewing that
Representative Frances Cavenaugh
Unverified
2:35:18
as you present. This bill is, is pretty simple. It's just saying that we can no longer require a preauthorization when there's a mental health crisis, um, currently some insurers do require that. This is just saying that it's not gonna happen. Um, I think the physical impact actually states that EBD won't have any. impact because we don't currently require one with our program, but there are other insurers that do, um, and for me it's really about a parity. I'm trying to get mental health
crisis on the same level as a physical health crisis because if neither one of them are addressed, it can result in the same. They Set to do. And I'd take any questions. All right, we're gonna, we're gonna
give committee time to review the fiscal impact. Representative McGee, you have a question? Theyry Kavanaugh, for bringing
Representative Richard McGrew
Unverified
2:36:16
this. I think it's an important issue. Do you have any idea?
How many prior authorizations are denied and then subsequently approved. I mean it's a, well, this
Representative Frances Cavenaugh
Unverified
2:36:28
was brought to me because we were working with our CSUs and the one in particular in Craighead County, they were having a big issue with when they would try to go in and get their services actually paid for by a private insurer because they happen to have a lot of people that come with private insurance, they were denied and their denial was there was no pre-authorization and so that's really what brought this to the
forefront is that we were seeing that these people were providing the service because it is a crisis. They're not turning them away, but then they, they could not get reimbursed for it they were being
Speaker 342
2:37:01
denied and being denied the reimburse. OK, thank you. Thank you, Mr. Chair. Any other questions by the committee? Seeing them,
we don't have anyone signed up to speak for or against. Is there anyone in the audience that would like to speak
for or against the bill? See none you recognized close for your bill. Members, I'd really
Representative Frances Cavenaugh
Unverified
2:37:18
appreciate a good vote on this. Like I said, I think this is as important as a mental
health crisis is as important as a physical health crisis because they both can end in the same unfortunate set of events which can be death to the person and I'm just trying to get parity and we all know that we have such a mental health crisis, not just in the state, but in the
nation, and I would appreciate a good vote. Representative Allen has a motion to pass any discussion on the motion? See none, all those in favor say aye. Opposed. Congratulations, Representative Kavanaugh, you passed your bill. Representative Mayberry.
Are you prepared to run 1164? You're recognized to identify yourself for the record and present your
Representative Julie Mayberry
Unverified
2:37:59
bill. State Representative Julie Mayberry and I'm going to bring along David Cook. I think he might have talked to some of you all. About this bill in advance, so hopefully it'll be
Samantha Crocker
Unverified
2:38:08
quick. Committee, this bill also has fiscal impact. Staff will hand that out now. You're recognized to present. My name is
David Cook
Unverified
2:38:15
David Cook. I'm the director of government affairs for the Alzheimer's Association. Um, members, this bill I filed
Representative Julie Mayberry
Unverified
2:38:25
January 16th and we um kept holding it because I
would get some feedback from a variety of people. We made some adjustments from the Arkansas Medical Society, they gave me a thumbs up. I just confirmed as they walked
out the door right then just making sure they didn't have any problems. We also made some amendments to address some concerns from some private health providers, Blue Cross Blue Shield, made some adjustments there, um, as you can see in the um, fiscal impact from EBD, um, which you'll, you'll be getting
now. It says this coverage for cognitive assessments was confirmed as already covered by the state health plan, so there's a negligible impact. What this bill will do is we'll help people um get cognitive assessments in a more timely fashion and um that is really important. This bill comes out of a working committee that we have. That Senator Penzo and I chair, um, called the Alzheimer's Disease and Dementia Advisory
Committee that we meet here at the state capitol with lots of different stakeholders, and this is one of the bills that um that committee endorsed and as a matter of fact, even our Department of Health, um,
added this to our state plan as an idea to help people in the state of Arkansas. And I'll let David share a
David Cook
Unverified
2:39:47
few words. Um, thank you, uh, Mr. Chair and committee members, um, thank you for the opportunity to speak on behalf of House Bill 1164 today. This legislation will expand access to cognitive assessments.
When we say assessments, we're not meaning a full diagnostic workup. Rather, these are um many cognitive assessments that can be performed in a doctor's office by an APRN or a PCP. Um, most commonly used is the MOCA, which is the Montreal cognitive assessment and it goes through a series of questions that test cognitive function, um, and again, these can happen inside of a doctor's office visit as well. Alzheimer's disease and other forms of dementia represent one of the most pressing health, public health crises of our time. Currently there's an
estimated 6.7 million Americans who are living with Alzheimer's, and that number is projected to double by 2060. Here in Arkansas, the impact is just as significant. Over 60,000 Arkansans over the age of 65 are currently living with Alzheimer's or another form of dementia. More than 11.3% of Arkansans over the age of 65 are living with this disease. In 2022, the behavioral risk factor surveillance is uh survey revealed that 11.5% of Arkansans over the age of 45 report that
they are experiencing confusion or memory loss that is happening more often or is getting worse. For those with worsening memory problems, 60% say that it, the problems are so severe that it's, it's created functional difficulties. Of that 60%, only 55% um or excuse me, 55% of that population have not discussed this with their provider. Which is indeed very uh concerning. These numbers will only continue to grow, increasing the burden on families, caregivers, and our healthcare system.
How about 1164 is a necessary step towards addressing this crisis by ensuring that cognitive assessments are covered by insurance, reducing the barriers to early detection and diagnosis. Early detection and diagnosis is critical for our disease space. Um, for the first time in history, it actually has medical benefits, um, individuals with an early diagnosis are able to access um treatments that have recently been approved by the FDA. But these treatments are only designed for a very specific patient. Individuals in the very early stages of mild cognitive
impairment or Alzheimer's disease, and also with the presence of amyloid plaque, which these treatments target, so an individual has to have a confirmed diagnosis in order to be eligible for these uh these treatments. The Alzheimer's Association estimates that every day in our country, 2000 people age out of eligibility for these treatments. So early detection and diagnosis is critical. Um, there's also other medical benefits, um, if a disease is caught early, um, participants and patients are able to participate in clinical trials and explore other treatment
options while they still have decision making capacity. According to research from the Lancet Commission on Dementia Prevention, intervention and care, addressing modifiable lifestyle factors could potentially prevent or delay up to 40 to 45% of dementia cases, meaning a significant portion of dementia cases could be impacted by lifestyle interventions such as a healthy diet, exercise, managing blood pressure, improving cardiovascular health and social engagement. The emotional and social benefits of uh an early
detection and diagnosis, um, a dementia diagnosis does not occur in a vacuum. It has a significant impact not only on the patient but on family caregivers. I think that's enough. Are
Representative Julie Mayberry
Unverified
2:43:15
there, are there questions? I know that the committee really, I'm sorry. Are you ready for
Speaker 351
2:43:21
questions? I'm, I'm OK. Wonderful. Thank you for being here.
Thank you for testifying. Any questions by the committee? Uh I've got a question if
you don't mind, and I'd just like some clarification. So I'm looking at the, the fiscal impact and you had talked about that was
negligible. Do you have a dollar amount? Is there somebody that can shed some light on what that dollar amount would be in terms of A negligible impact because I, I would assume it has to do with utilization, right? Correct. So do we know what the cost of an assessment is or what's the utilization of the assessment has
David Cook
Unverified
2:43:57
been. Yeah, so, uh, according to Siegel's analysis, the EBD plan already covers that. They may, um, the, the fiscal impact statement did say that that
utilization could increase, um, but we narrowed the scope of the patient, so it has to be a patient over the age of 45, who the physician deems as being at a high risk for developing dementia, um, we're over the age of 60. Uh, we, we can't afford to uh refer to this disease as an aging disease. Younger populations are getting diagnosed, so we didn't narrow the scope of the patient to ease the financial um impact on this this legislation, and allowed for
Representative Julie Mayberry
Unverified
2:44:31
copayment as well, so it's not completely on the insurance company to pay for the whole thing, so we made all those adjustments. We've taken every
suggestion that anyone has given to us and put it
into the bill. Thank you for working with with everyone. I appreciate that. I, I'm gonna ask DHS kind of off the cuff
if somebody can come and just give us an idea on what the utilization rate may have been, may, uh, what that impact may be or what the assessment cost is if you have that information offhand. If not, you can get it to us offline.
Speaker 170
2:45:09
Good afternoon, Elizabeth Pittman, division of Medical Services. Um, we have done some preliminary fiscal impacts based on a range of utilization uptake, um, that range is based on the bill's new definition. We did do it on the amendment, um. And it ranges anywhere from 3.7 to $7.1 million of the state share. That's a 12.7 to $24.5 million dollar total computable impact and that's based on the Medicare rate for the assessment code that we found of $268.
Representative Julie Mayberry
Unverified
2:45:42
This is brand new information. This has been filed since January. I would have appreciated a little bit of a heads
up on, on, on this information, this is brand new to me, and again, this kind of came from the Alzheimer's
disease and dementia advisory, um, committee of which um the Department of Health, you know, very much was encouraging this to be in our state Alzheimer's plan. Thank you,
Representative, and, and I appreciate um your, your
thoughts on that and obviously, this is what the committee process is for, so we want to make sure that we're doing our due diligence, that we're vetting, uh, each piece of legislation that comes before us, so uh I understand you'd like to have had that beforehand and I don't disagree with you, uh, but we do have that information now. So is there any questions of the committee? And I'll just apologize if it's new information,
Speaker 356
2:46:35
my understanding was we had met with you on this, so I apologize for that. Never ever was there
any type of fiscal impact or or anything that I have record of. OK, well,
David Cook
Unverified
2:46:53
let's do you have something to add, sir? Yeah, she is right, the billing code as exists in Arkansas um could join 21 other states who established a reimbursement rate for this this billing code, the average that we're seeing across the states is not the 268 numbers around 165 to 225 depending on the state. Louisiana has established uh coverage for this billing code. Um, and, and we know that in
Tennessee there's legislation moving forward that will establish a reimbursement rate. We've certainly given DHS an opportunity to establish that rate and and have talked about this in the past. Um, but, but given that the high risk, uh, I would love to see how they got to that number, because we're not seeing that in other states. It's not like every, every individual who's eligible for Medicaid is going to rush out and get an assessment. The physician does have to uh qualify that patient and the CPT code that she does reference does have a clinical protocol that must be followed in order for the reimbursement to be
issued to the provider in terms of other tests that have to be done prior to
Speaker 327
2:47:50
this, so, um, We would disagree with that, that fiscal impact on our side, understood, and we'll
Speaker 357
2:47:54
be happy to share that with Representative Mae Berry. So Again,
it's important that we get this right. I think what you're doing is, is a great thing. Um, is this something you want
to continue forward with today? Do you want to pull this back and let's have some
Representative Julie Mayberry
Unverified
2:48:07
conversation would be willing to have some conversation. I, I certainly don't want to move forward, as I said, I'm just now getting this information if it
was given to me ahead of time,
I, I'm, I'm not aware of it. I don't recall it. I don't remember ever hearing that amount. So, um, I will be happy as any bill I ever file, I want to hear from anybody who's Concerned and see if we can make some adjustments to
Representative Fred Allen
Unverified
2:48:33
it. Representative Allen, you recognize for a question. Thank you, Mr. Chairman. Thank you for what you're trying to do. Representing Mayberry and I, I can empathize with you because Uh, to
To file a bill and work on it for several months and then all of a sudden somebody hops down at the end of the table, give you bad news, uh, and give you a physical impact statement, something that you just totally blindsided by and I, I know how you feel because I've had that to happen to me in the past, so I think that when these bills are filed, I think they need to do a better job of getting the information to the representative before he or she goes down to the end of the table and Star is in the bill.
Representative Julie Mayberry
Unverified
2:49:18
Because it's just totally throws everything off track. Thank you. And, and I do understand there's a lot of bills that are filed. We have had many conversations with DHS as you know, the dental stuff. We, we have had many zooms, so it may have been something that has just been overlooked and so
Speaker 274
2:49:36
we'll, we'll discuss offline and we'll come back. And again, I apologize if it wasn't intentional
Representative Fred Allen
Unverified
2:49:41
all of you know, I didn't say it was intentional. I wouldn't, I wouldn't think that you would do anything like that.
OK. Thank you. Thank you for your question, Representative Allen. Any other questions by the committee? See none are you making a request to pull this bill back? We'll honor that request. Committee members seeing no further business for today. We're gonna continue with fiscal impact bills as we get them on Thursday. We also will continue to hear things that are on our regular agenda. If you have bills that are on the deferred agenda, please uh send Shanice and other staff members, a message getting those moved to regular or look at withdrawing
Agenda
REGULAR AGENDA
HB1468 Cozart TO AMEND ARKANSAS LAW CONCERNING CLAIMS AGAINST CONTRACTORS AND SUPPLIERS TO REMEDY CONSTRUCTION DEFECTS.
HB1530 Achor TO AMEND THE DEFINITION OF "SPECIALTY HOSPITAL" RELATING TO THE ASSESSMENT FEE ON HOSPITALS UNDER THE ARKANSAS MEDICAID PROGRAM.
HB1543 Underwood TO ESTABLISH THE WORKFORCE EXPERIENCE OPPORTUNITIES ACT OF 2025.
HB1582 McAlindon TO REQUIRE AN INDIVIDUAL TO TAKE CERTAIN ACTIONS TO BE ELIGIBLE FOR BENEFITS UNDER THE DIVISION OF WORKFORCE SERVICES LAW.
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.
HB1592 J. Mayberry TO CREATE THE ARKANSAS ALZHEIMER'S AND DEMENTIA PUBLIC HEALTH ACT.
SB257 C. Penzo TO AMEND THE MEDICAID FAIRNESS ACT; TO EXTEND THE APPEAL PERIOD FOR PROVIDERS IN THE ARKANSAS MEDICAID PROGRAM; AND TO REQUIRE COMPREHENSIVE INFORMATION IN NOTICES OF ADVERSE DECISIONS.
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.
SB111 K. Hammer TO ESTABLISH THE DENTIST AND DENTAL HYGIENIST COMPACT.
SB99 C. Penzo TO AUTHORIZE A PHYSICIAN ASSISTANT TO DELEGATE CERTAIN TASKS.
SB101 C. Penzo TO ESTABLISH THE PHYSICIAN ASSISTANT LICENSURE COMPACT.
SB118 C. Penzo TO AMEND THE DEFINITION OF "AUDIOLOGY" RELATING TO THE PRACTICE OF AUDIOLOGISTS.Bentley
HB1653 Cavenaugh TO SET STANDARDS FOR THE LICENSING AND REGULATION OF PSYCHIATRIC RESIDENTIAL TREATMENT FACILITIES.
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.
SB100 C. Penzo TO AUTHORIZE THE ARKANSAS MEDICAID PROGRAM TO RECOGNIZE A PHYSICIAN ASSISTANT AS A PRIMARY CARE PROVIDER.
HB1079 F. Allen TO MANDATE COVERAGE FOR GENETIC TESTING FOR AN INHERITED GENE MUTATION FOR CERTAIN INDIVIDUALS; AND TO MANDATE COVERAGE FOR EVIDENCE-BASED CANCER IMAGING FOR CERTAIN INDIVIDUALS.
HB1164 J. Mayberry TO ALLOW A PHYSICIAN OR HEALTHCARE PROVIDER TO OFFER COGNITIVE ASSESSMENTS FOR CERTAIN PATIENTS; AND TO MANDATE THAT INSURANCE POLICIES COVER ASSESSMENTS FOR COGNITIVE FUNCTION FOR CERTAIN PATIENTS.
HB1275 Cavenaugh TO PROHIBIT PRIOR AUTHORIZATIONS FOR HEALTHCARE SERVICES PROVIDED FOR TREATMENT OF A MENTAL HEALTH CRISIS.
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.
HB1505 Wing TO REQUIRE A PUBLIC EMPLOYER TO OFFER AND PROVIDE COVERAGE FOR LICENSED COUNSELING FOR A PUBLIC SAFETY EMPLOYEE WHO HAS EXPERIENCED A TRAUMATIC EVENT.
HB1218 J. Mayberry TO CREATE LICENSURE FOR THERAPEUTIC RECREATION SPECIALISTS; AND TO CREATE THE THERAPEUTIC RECREATION PRACTICE ACT.
HB1241 J. Mayberry TO ENSURE THAT THE ARKANSAS MEDICAID PROGRAM REIMBURSES FOR DENTAL AND ANESTHESIA COSTS FOR HIGH COMPLEXITY ORAL HEALTH CARE.
HB1004 Pilkington TO REQUIRE MEDICAID COVERAGE FOR POSTPARTUM MOTHERS FOR ONE YEAR AFTER GIVING BIRTH.
HB1682 Puryear TO CREATE THE GOOD NEIGHBOR ACT; AND TO CLARIFY FOOD DONATION LIABILITY AND IMMUNITY.
SB189 A. Clark TO AUTHORIZE IVERMECTIN FOR HUMAN USE TO BE SOLD WITHOUT A PRESCRIPTION OR CONSULTATION WITH A HEALTHCARE PROFESSIONAL.
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.
Documents
| Title | Type | Pages | Source |
|---|---|---|---|
| Agenda — PUBLIC HEALTH, WELFARE AND LABOR COMMITTEE- HOUSE, Mar 11, 2025 | Agenda | 4 | Official source ↗ |
Speakers
Representative Jeremy Wooldridge Chair
Unverified
Speaker 4
Zach Gramlich
Unverified
Speaker 9
Speaker 10
Speaker 11
Representative R. Scott Richardson
Unverified
Speaker 24
Speaker 28
Representative Kenneth B. Ferguson
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Speaker 50
Speaker 70
Speaker 71
Representative Denise Jones Ennett
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Representative Julie Mayberry
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Speaker 100
Speaker 102
Speaker 104
Chair
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Representative Ryan A. Rose
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Representative Lee Johnson
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Speaker 132
Speaker 134
Samantha Crocker
Unverified
Speaker 143
Teresa Dodson
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Steven Barry
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Speaker 158
Speaker 164
Speaker 168
Speaker 170
Speaker 166
Speaker 191
Speaker 92
Speaker 202
Speaker 204
Representative Carlton Wing
Unverified
Speaker 218
Speaker 222
Speaker 26
Speaker 83
Speaker 227
Speaker 230
Speaker 231
Speaker 225
Representative Aaron Pilkington
Unverified
Ken Slocum
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Speaker 240
Speaker 242
Representative Chad Puryear
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Speaker 78
Speaker 30
Speaker 249
Katie Hall
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Speaker 253
Speaker 259
Speaker 82
Tyler Rollins
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Speaker 270
Speaker 272
Speaker 276
Speaker 277
Representative Mary Bentley
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Kelly Linton
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Speaker 282
Senator Jane English
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Speaker 300
Speaker 309
Speaker 310
Speaker 311
Speaker 314
Speaker 296
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Speaker 321
Speaker 326
Speaker 327
Speaker 329
Speaker 336
Representative Richard McGrew
Unverified
Representative Frances Cavenaugh
Unverified
Speaker 342
David Cook
Unverified
Speaker 351
Speaker 356
Speaker 357
Representative Fred Allen
Unverified
Speaker 274