Public Health, Welfare and Labor Committee - Senate
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Bills discussed (52)
| Bill | Title | Sponsor | Status |
|---|---|---|---|
|
HB1245
Act 432
· 4 mentions in agenda, chapter, transcript
Matched: “…ck J. Love RE-REFERRED TO COMMITTEE Number Sponsor Subtitle HB1245 Clowney TO CREATE THE ARKANSAS BEHAVIOR ANALYST REGISTRATIO…”
|
TO CREATE THE ARKANSAS BEHAVIOR ANALYST REGISTRATION ACT. | Clowney | Notification that HB1245 is now Act 432 |
|
SB189
Act 396
· 3 mentions in agenda, chapter, transcript
Matched: “…ST REGISTRATION ACT. REGULAR AGENDA Number Sponsor Subtitle 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 |
|
SB269
· 3 mentions in agenda, chapter, transcript
Matched: “…EQUIRE DIALYSIS CENTERS TO HAVE A BACKUP GENERATOR ON SITE. SB269 C. Penzo TO AMEND THE REQUIREMENTS REGARDING LOCATIONS FOR…”
|
TO AMEND THE REQUIREMENTS REGARDING LOCATIONS FOR AND GEOGRAPHIC AREAS OF A HOSPICE AGENCY. | C. Penzo | Died in Senate Committee at Sine Die adjournment. |
|
HB1182
Act 265
· 2 mentions in chapter, agenda
Matched: “HB1182 Bentley TO REPLACE THE DEFINED TERM "MEDICATION ASSISTIVE P…”
|
TO REPLACE THE DEFINED TERM "MEDICATION ASSISTIVE PERSON" WITH THE DEFINED TERM "CERTIFIED MEDICATION ASSISTANT" … | Bentley | Notification that HB1182 is now Act 265 |
|
SB284
· 2 mentions in chapter, agenda
Matched: “SB284 J. Payton TO MODIFY THE EMPLOYER'S LIABILITY UNDER THE WORK…”
|
TO MODIFY THE EMPLOYER'S LIABILITY UNDER THE WORKERS' COMPENSATION LAW THAT RESULTED FROM INITIATED MEASURE … | J. Payton | Sine Die adjournment |
|
SB285
· 2 mentions in chapter, agenda
Matched: “SB285 J. Payton TO MODIFY THE COMPENSATION RESTRICTIONS UNDER THE…”
|
TO MODIFY THE COMPENSATION RESTRICTIONS UNDER THE WORKERS' COMPENSATION LAW THAT RESULTED FROM INITIATED ACT … | J. Payton | Sine Die adjournment |
|
SB286
· 2 mentions in chapter, agenda
Matched: “SB286 J. Payton TO ALLOW ADDITIONAL WAGE LOSS BENEFITS IN ADDITIO…”
|
TO ALLOW ADDITIONAL WAGE LOSS BENEFITS IN ADDITION TO SCHEDULED INJURY PAYMENTS UNDER THE WORKERS' … | J. Payton | Sine Die adjournment |
|
SB287
· 2 mentions in chapter, agenda
Matched: “SB287 J. Payton TO MODIFY CERTAIN ATTORNEY FEES FOR CONTROVERTED…”
|
TO MODIFY CERTAIN ATTORNEY FEES FOR CONTROVERTED MEDICAL EXPENSES, APPEALS, AND CHANGES OF PHYSICIANS UNDER … | J. Payton | Sine Die adjournment |
|
SB288
· 2 mentions in chapter, agenda
Matched: “SB288 J. Payton TO MODIFY A PHYSICIAN CHANGE UNDER THE WORKERS' C…”
|
TO MODIFY A PHYSICIAN CHANGE UNDER THE WORKERS' COMPENSATION LAW THAT RESULTED FROM INITIATED MEASURE … | J. Payton | Sine Die adjournment |
|
SB371
Act 653
· 2 mentions in chapter, agenda
Matched: “SB371 J. Scott TO ESTABLISH A STANDARDIZED SYSTEM TO AID IN THE S…”
|
TO ESTABLISH A STANDARDIZED SYSTEM TO AID IN THE SEARCH OF MISSING CHILDREN WHO DO … | J. Scott | Notification that SB371 is now Act 653 |
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HB1167
Act 431
· 1 mention in agenda
Matched: “…AND COSMETIC ACT; AND TO DECLARE AN EMERGENCY. Page 2 of 4 HB1167 L. Johnson TO MODIFY THE SIGNATURE AUTHORITY FOR ADVANCED P…”
|
TO MODIFY THE SIGNATURE AUTHORITY FOR ADVANCED PRACTICE REGISTERED NURSES AND PHYSICIAN ASSISTANTS; AND TO … | L. Johnson | Notification that HB1167 is now Act 431 |
|
HB1171
Act 625
· 1 mention in agenda
Matched: “…L BEDS WITHIN PSYCHIATRIC RESIDENTIAL TREATMENT FACILITIES. HB1171 K. Moore TO MODIFY THE MEDICAID PROVIDER-LED ORGANIZED CARE…”
|
TO MODIFY THE MEDICAID PROVIDER-LED ORGANIZED CARE ACT; AND TO AUTHORIZE AN ABBREVIATED INDEPENDENT ASSESSMENT … | K. Moore | Notification that HB1171 is now Act 625 |
|
HB1186
Act 960
· 1 mention in agenda
Matched: “…VIDE A CATEGORY FOR BENEFICIARIES WITH SICKLE CELL DISEASE. HB1186 Vaught TO CREATE THE PAIN RELIEF PARITY ACT; AND TO REQUIRE…”
|
TO CREATE THE PAIN RELIEF PARITY ACT; AND TO REQUIRE PAIN RELIEF PARITY IN THE … | Vaught | Notification that HB1186 is now Act 960 |
|
HB1192
· 1 mention in transcript
Matched: “House Bill 1192 is um a really critical and important bill for our uh long-…”
|
TO PROHIBIT THE POSSESSION OF TOBACCO, TOBACCO PRODUCTS, AND E-CIGARETTES BY STUDENTS; AND TO REQUIRE … | Pilkington | Died in House Committee at Sine Die adjournment. |
|
HB1251
· 1 mention in agenda
Matched: “…SION TO BE AN ADVISORY COUNCIL TO THE DEPARTMENT OF HEALTH. HB1251 L. Johnson TO ESTABLISH THE ARKANSAS ANESTHESIOLOGIST ASSIS…”
|
TO ESTABLISH THE ARKANSAS ANESTHESIOLOGIST ASSISTANT ACT; AND TO PROVIDE FOR LICENSURE OF ANESTHESIOLOGIST ASSISTANTS. | L. Johnson | Died in Senate Committee at Sine Die adjournment. |
|
HB1254
Act 433
· 1 mention in agenda
Matched: “…MEDICAL EQUIPMENT INCLUDES DIABETIC SHOES AND SHOE INSERTS. HB1254 L. Johnson TO AUTHORIZE A LICENSED PSYCHOLOGICAL PRACTITION…”
|
TO AUTHORIZE A LICENSED PSYCHOLOGICAL PRACTITIONER TO PRACTICE INDEPENDENTLY IN THIS STATE; AND TO REMOVE … | L. Johnson | Notification that HB1254 is now Act 433 |
|
HB1257
Act 434
· 1 mention in agenda
Matched: “…HE ARKANSAS PRIMARY CARE PAYMENT IMPROVEMENT WORKING GROUP. HB1257 L. Johnson TO REMOVE THE LIMITATION OF THE PRACTICE OF NEUR…”
|
TO REMOVE THE LIMITATION OF THE PRACTICE OF NEUROPSYCHOLOGY FROM TECHNICIANS EMPLOYED BY PSYCHOLOGISTS; AND … | L. Johnson | Notification that HB1257 is now Act 434 |
|
HB1258
Act 435
· 1 mention in agenda
Matched: “…DEPENDENT PRACTICE PRIVILEGES FROM PSYCHOLOGICAL EXAMINERS. HB1258 L. Johnson TO CREATE THE COMMUNITY HEALTH WORKER ACT; AND T…”
|
TO CREATE THE COMMUNITY HEALTH WORKER ACT; AND TO ESTABLISH A STATEWIDE CERTIFICATION FOR COMMUNITY … | L. Johnson | Notification that HB1258 is now Act 435 |
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HB1291
Act 385
· 1 mention in agenda
Matched: “…NEFICIARIES ENROLLED IN A RISK-BASED PROVIDER ORGANIZATION. HB1291 Wing TO EXCLUDE CERTAIN MINOR LEAGUE BASEBALL PLAYERS FROM…”
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TO EXCLUDE CERTAIN MINOR LEAGUE BASEBALL PLAYERS FROM THE DEFINITION OF "EMPLOYEE" UNDER THE MINIMUM … | Wing | Notification that HB1291 is now Act 385 |
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HB1382
Act 481
· 1 mention in agenda
Matched: “…EQUIRE PAIN RELIEF PARITY IN THE ARKANSAS MEDICAID PROGRAM. HB1382 Ladyman TO REQUIRE CERTAIN REPORTING BY THE DESIGNATED PROT…”
|
TO REQUIRE CERTAIN REPORTING BY THE DESIGNATED PROTECTION AND ADVOCACY AGENCY FOR THE STATE AND … | Ladyman | Notification that HB1382 is now Act 481 |
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HB1403
· 1 mention in agenda
Matched: “…S IMPACTING THE LAW RESULTING FROM INITIATED ACT 5 OF 2018. HB1403 Pilkington TO AMEND THE ARKANSAS HEALTH AND OPPORTUNITY FOR…”
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TO AMEND THE ARKANSAS HEALTH AND OPPORTUNITY FOR ME ACT OF 2021 TO ALLOW NONHOSPITAL … | Pilkington | Died in Senate Committee at Sine Die adjournment. |
|
HB1428
Act 855
· 1 mention in agenda
Matched: “…THE ARKANSAS MEDICAID PROGRAM; AND TO DECLARE AN EMERGENCY. HB1428 Steimel TO AMEND THE LAW REGARDING PUBLIC LODGING; AND TO P…”
|
TO AMEND THE LAW REGARDING PUBLIC LODGING; AND TO PROVIDE A BED HEIGHT REQUIREMENT FOR … | Steimel | Notification that HB1428 is now Act 855 |
|
HB1439
Act 853
· 1 mention in agenda
Matched: “…NONHOSPITAL ENTITIES TO BE COMMUNITY BRIDGE ORGANIZATIONS. HB1439 Ladyman TO REMOVE THE CERTIFICATION PROCESS OF THE DEPARTME…”
|
TO REMOVE THE CERTIFICATION PROCESS OF THE DEPARTMENT OF HUMAN SERVICES FROM LICENSURE AS A … | Ladyman | Notification that HB1439 is now Act 853 |
|
HB1440
Act 629
· 1 mention in agenda
Matched: “…OF HUMAN SERVICES FROM LICENSURE AS A PRIVATE CARE AGENCY. HB1440 Bentley TO AMEND THE MASSAGE THERAPY ACT; AND TO ESTABLISH…”
|
TO AMEND THE MASSAGE THERAPY ACT; AND TO ESTABLISH REGISTRATION FOR MASSAGE THERAPY ESTABLISHMENTS. | Bentley | Notification that HB1440 is now Act 629 |
|
HB1442
· 1 mention in agenda
Matched: “…ERT SYSTEM; AND TO CREATE THE ARKANSAS PURPLE ALERT SYSTEM. HB1442 Achor TO SET RESTRICTIONS ON PHARMACY CONTRACTING AND CONFL…”
|
TO SET RESTRICTIONS ON PHARMACY CONTRACTING AND CONFLICTS OF INTEREST; AND TO ESTABLISH PHARMACEUTICAL PATIENT … | Achor | Died in Senate Committee at Sine Die adjournment. |
|
HB1454
Act 674
· 1 mention in agenda
Matched: “…GISTRATION FOR MASSAGE THERAPY ESTABLISHMENTS. Page 3 of 4 HB1454 Bentley TO AMEND THE LAWS CONCERNING CRIMINAL HISTORY RECOR…”
|
TO AMEND THE LAWS CONCERNING CRIMINAL HISTORY RECORDS CHECKS FOR EMPLOYEES OF SERVICE PROVIDERS; TO … | Bentley | Notification that HB1454 is now Act 674 |
|
HB1458
Act 851
· 1 mention in agenda
Matched: “…ND TO PROVIDE FOR LICENSURE OF ANESTHESIOLOGIST ASSISTANTS. HB1458 L. Johnson TO AMEND THE DEFINITION OF "CREDENTIALING INFORM…”
|
TO AMEND THE DEFINITION OF "CREDENTIALING INFORMATION" WHEN THE ARKANSAS STATE MEDICAL BOARD IS PROVIDING … | L. Johnson | Notification that HB1458 is now Act 851 |
|
HB1471
Act 966
· 1 mention in agenda
Matched: “…AND TO ESTABLISH PHARMACEUTICAL PATIENT FREEDOM OF CHOICE. HB1471 Wooldridge TO AMEND THE EXPIRATION DATE OF ALL LICENSES OF…”
|
TO AMEND THE EXPIRATION DATE OF ALL LICENSES OF THE BOARD OF EXAMINERS IN SPEECH-LANGUAGE … | Wooldridge | Notification that HB1471 is now Act 966 |
|
HB1537
Act 850
· 1 mention in agenda
Matched: “…RD IS PROVIDING INFORMATION TO CREDENTIALING ORGANIZATIONS. HB1537 Ladyman TO REPEAL THE LOCATION ACT FOR COMMUNITY HOMES FOR…”
|
TO REPEAL THE LOCATION ACT FOR COMMUNITY HOMES FOR INDIVIDUALS WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES. | Ladyman | Notification that HB1537 is now Act 850 |
|
SB117
· 1 mention in agenda
Matched: “…SAS MEDICAID PROGRAM TO PERFORM ADDITIONAL CARE AND DUTIES. SB117 C. Penzo TO CREATE THE NATUROPATHIC PHYSICIAN PRACTICE ACT;…”
|
TO CREATE THE NATUROPATHIC PHYSICIAN PRACTICE ACT; TO PROVIDE FOR LICENSURE OF NATUROPATHIC PHYSICIANS IN … | C. Penzo | Died in House Committee at Sine Die adjournment. |
|
SB120
· 1 mention in agenda
Matched: “…SAS; AND TO CREATE THE ARKANSAS STATE BOARD OF NATUROPATHY. SB120 C. Penzo TO REQUIRE LICENSURE FOR ALL PRIVATE CARE AGENCIES…”
|
TO REQUIRE LICENSURE FOR ALL PRIVATE CARE AGENCIES IN THIS STATE; AND TO ENSURE CONSUMER … | C. Penzo | Died in House Committee at Sine Die adjournment. |
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SB121
Act 968
· 1 mention in agenda
Matched: “…TO ENSURE CONSUMER PROTECTION FOR VULNERABLE AGING ADULTS. SB121 C. Penzo TO AMEND THE AUTOMATIC OCCUPATIONAL LICENSURE FOR…”
|
TO AMEND THE AUTOMATIC OCCUPATIONAL LICENSURE FOR OUT-OF-STATE LICENSURE ACT; TO APPLY THE AUTOMATIC OCCUPATIONAL … | C. Penzo | Notification that SB121 is now Act 968 |
|
SB122
· 1 mention in agenda
Matched: “…URE FOR OUT-OF-STATE LICENSURE ACT TO PHYSICIAN ASSISTANTS. SB122 C. Penzo TO AMEND THE AUTOMATIC OCCUPATIONAL LICENSURE FOR…”
|
TO AMEND THE AUTOMATIC OCCUPATIONAL LICENSURE FOR OUT-OF-STATE LICENSURE ACT; TO APPLY THE AUTOMATIC OCCUPATIONAL … | C. Penzo | Died on House Calendar at Sine Die adjournment. |
|
SB2
· 1 mention in agenda
Matched: “…rs and Staff Only'. DEFERRED BILLS Number Sponsor Subtitle SB2 C. Penzo TO REPEAL THE STATEWIDE FLUORIDATION PROGRAM; AND…”
|
TO REPEAL THE STATEWIDE FLUORIDATION PROGRAM; AND TO REMOVE THE MANDATE FOR WATER SYSTEMS TO … | C. Penzo | Died in House Committee at Sine Die adjournment. |
|
SB217
Act 969
· 1 mention in agenda
Matched: “…NAL LICENSURE FOR OUT-OF-STATE LICENSURE ACT TO PHYSICIANS. SB217 C. Penzo TO REQUIRE THE DEPARTMENT OF HUMAN SERVICES TO REQ…”
|
TO REQUIRE THE DEPARTMENT OF HUMAN SERVICES TO REQUEST A WAIVER TO EXCLUDE CANDY AND … | C. Penzo | Notification that SB217 is now Act 969 |
|
SB221
· 1 mention in agenda
Matched: “…FOODS UNDER THE SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM. SB221 B. Davis TO PROHIBIT RISK-BASED PROVIDER ORGANIZATIONS FROM…”
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TO PROHIBIT RISK-BASED PROVIDER ORGANIZATIONS FROM USING CERTAIN TYPES OF CONTRACTING PRACTICES WHEN CONTRACTING WITH … | B. Davis | Died in Senate Committee at Sine Die adjournment. |
|
SB225
· 1 mention in agenda
Matched: “…OVIDER-LED ORGANIZED CARE ACT; AND TO DECLARE AN EMERGENCY. SB225 J. Scott TO REQUIRE THE ARKANSAS MEDICAID PROGRAM TO PROVID…”
|
TO REQUIRE THE ARKANSAS MEDICAID PROGRAM TO PROVIDE A CATEGORY FOR BENEFICIARIES WITH SICKLE CELL … | J. Scott | Died in Senate Committee at Sine Die adjournment. |
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SB235
· 1 mention in agenda
Matched: “…AND THE DESIGNATED CLIENT ASSISTANCE PROGRAM FOR THE STATE. SB235 J. Boyd TO CREATE THE VOLUNTARY PORTABLE BENEFIT ACCOUNT AC…”
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TO CREATE THE VOLUNTARY PORTABLE BENEFIT ACCOUNT ACT. | J. Boyd | Sine Die adjournment |
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SB255
· 1 mention in agenda
Matched: “…AIN TASKS TO MEDICAL ASSISTANTS AND OTHER UNLICENSED STAFF. SB255 C. Penzo TO AMEND THE DEFINITION OF "DRUG" WITHIN THE FOOD,…”
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TO AMEND THE DEFINITION OF "DRUG" WITHIN THE FOOD, DRUG, AND COSMETIC ACT; AND TO … | C. Penzo | Died in House Committee at Sine Die adjournment. |
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SB262
· 1 mention in agenda
Matched: “…ISH A STATEWIDE CERTIFICATION FOR COMMUNITY HEALTH WORKERS. SB262 C. Penzo TO AMEND THE CORPORATE PRACTICE OF MEDICINE DOCTRI…”
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TO AMEND THE CORPORATE PRACTICE OF MEDICINE DOCTRINE; AND TO AUTHORIZE A LICENSED MEDICAL PROFESSIONAL … | C. Penzo | Died on House Calendar at Sine Die adjournment. |
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SB264
Act 483
· 1 mention in agenda
Matched: “…MAINTAIN OWNERSHIP UPON AN INACTIVE LICENSE OR RETIREMENT. SB264 Irvin TO ESTABLISH THE ARKANSAS PRIMARY CARE PAYMENT IMPROV…”
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TO ESTABLISH THE ARKANSAS PRIMARY CARE PAYMENT IMPROVEMENT WORKING GROUP. | Irvin | Notification that SB264 is now Act 483 |
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SB273
· 1 mention in agenda
Matched: “…IFIED MEDICATION ASSISTANT" THROUGHOUT § 17-87- 701 ET SEQ. SB273 D. Wallace TO REQUIRE DIALYSIS CENTERS TO HAVE A BACKUP GEN…”
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TO REQUIRE DIALYSIS CENTERS TO HAVE A BACKUP GENERATOR ON SITE. | D. Wallace | Died in Senate Committee at Sine Die adjournment. |
|
SB278
Act 438
· 1 mention in agenda
Matched: “…LOW PSYCHOLOGY TECHNICIANS TO BE EMPLOYED BY PSYCHOLOGISTS. SB278 J. English TO REPEAL THE STATUTES CONCERNING THE OCCUPATION…”
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TO REPEAL THE STATUTES CONCERNING THE OCCUPATIONAL AUTHORIZATION AND LICENSURE OF CERTAIN EMPLOYMENT OFFICES AND … | J. English | Notification that SB278 is now Act 438 |
|
SB279
Act 397
· 1 mention in agenda
Matched: “…REPEAL THE ARKANSAS PRIVATE EMPLOYMENT AGENCY ACT OF 1975. SB279 Irvin TO ASSIST THE DIVISION OF LABOR WITH ENFORCING THE FA…”
|
TO ASSIST THE DIVISION OF LABOR WITH ENFORCING THE FAIR AND PROMPT PAYMENT OF WAGES … | Irvin | Notification that SB279 is now Act 397 |
|
SB306
· 1 mention in agenda
Matched: “…MANNER IN WHICH WAGE AND HOUR COMPLAINTS ARE INVESTIGATED. SB306 C. Penzo TO REQUIRE THE DEPARTMENT OF HUMAN SERVICES TO APP…”
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TO REQUIRE THE DEPARTMENT OF HUMAN SERVICES TO APPLY FOR A HOME- AND COMMUNITY-BASED SERVICES … | C. Penzo | Died in Senate Committee at Sine Die adjournment. |
|
SB311
Act 772
· 1 mention in agenda
Matched: “…WAIVER FOR THE AGING AND ELDERLY POPULATION IN THIS STATE. SB311 C. Penzo TO CREATE THE END ORGAN AND GENOMIC HARVESTING ACT…”
|
TO CREATE THE END ORGAN AND GENOMIC HARVESTING ACT; TO PROHIBIT COVERAGE OF CERTAIN HUMAN … | C. Penzo | Notification that SB311 is now Act 772 |
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SB312
· 1 mention in agenda
Matched: “…RTAIN GENETIC SEQUENCERS AND GENETIC ANALYSIS TECHNOLOGIES. SB312 Stone TO REMOVE THE MORATORIUM ON THE CONSTRUCTION OR ADDIT…”
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TO REMOVE THE MORATORIUM ON THE CONSTRUCTION OR ADDITION OF ANY ADDITIONAL BEDS WITHIN PSYCHIATRIC … | Stone | Died in Senate Committee at Sine Die adjournment. |
|
SB347
Act 1025
· 1 mention in agenda
Matched: “…DIVIDUALS WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES. SB347 C. Penzo TO REQUIRE THE ARKANSAS MEDICAID PROGRAM TO INCREA…”
|
TO REQUIRE THE ARKANSAS MEDICAID PROGRAM TO INCREASE REIMBURSEMENT RATES FOR CERTAIN DENTAL SERVICES AND … | C. Penzo | Notification that SB347 is now Act 1025 |
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SB348
Act 567
· 1 mention in agenda
Matched: “…SET AN ANNUAL REIMBURSEMENT CAP FOR ADULT DENTAL SERVICES. SB348 C. Penzo TO AMEND THE ANNUAL CAP FOR DIAGNOSTIC LABORATORY…”
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TO AMEND THE ANNUAL CAP FOR DIAGNOSTIC LABORATORY SERVICES WITHIN THE ARKANSAS MEDICAID PROGRAM; AND … | C. Penzo | Notification that SB348 is now Act 567 |
|
SB367
Act 735
· 1 mention in agenda
Matched: “…RD OF EXAMINERS IN SPEECH-LANGUAGE PATHOLOGY AND AUDIOLOGY. SB367 Irvin TO REPEAL THE SMALL BUSINESS REVOLVING LOAN FUND FOR…”
|
TO REPEAL THE SMALL BUSINESS REVOLVING LOAN FUND FOR POLLUTION CONTROL AND PREVENTION TECHNOLOGIES ACT; … | Irvin | Notification that SB367 is now Act 735 |
|
SB9
Act 622
· 1 mention in agenda
Matched: “…E MANDATE FOR WATER SYSTEMS TO MAINTAIN A FLUORIDE CONTENT. SB9 B. Davis TO CREATE THE MAKE ARKANSAS HEALTHY AGAIN ACT; AND…”
|
TO CREATE THE MAKE ARKANSAS HEALTHY AGAIN ACT; AND TO PROHIBIT MANUFACTURING, SELLING, DELIVERING, DISTRIBUTING, … | B. Davis | Notification that SB9 is now Act 622 |
|
SB95
· 1 mention in agenda
Matched: “…G FOR SALE A FOOD PRODUCT THAT CONTAINS CERTAIN SUBSTANCES. SB95 C. Penzo TO AMEND THE ARKANSAS ATHLETIC TRAINERS ACT; AND T…”
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TO AMEND THE ARKANSAS ATHLETIC TRAINERS ACT; AND TO CLARIFY THE DEFINITION OF "ATHLETE" WITHIN … | C. Penzo | Died in Senate Committee at Sine Die adjournment. |
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Right, if you'll please proceed. Senate Bill 189. Thank you,
Senator Alan Clark
Unverified
0:17
Madam Chair. The this is Simple one-page bill. Uh,
that is just catching up. The law with practice, what's actually happening in the world. Uh, people are using ivermectin. They're using ivermectin safely, uh, but for the most part, I shouldn't say for the most
part, large uh large group of people are going to the ag store. And buying Ivermectin that's uh mixed and designed for animals and has to be able to do the math calculations as to how much they should take versus being able to get just regular ivermectin, uh, That is made for people, not that there's a difference in the drug itself. Uh But it would be safer if they were using that that was designed for human use.
Uh The words in the bill that are added to the law as ivermectin without prescription or consultation with healthcare professionals as using this section over the counter medication means medication that may be legally sold and purchased without a prescription, notwithstanding any law to the contrary, Iremectin suitable for human use may be sold or purchased as an over the counter medication in this state without a prescription or consultation with the healthcare professional. The
The first thing that's going to come up with a drug is safety. The There was a study done from May of 2020 to uh December 2021. I didn't bring that one with me. Uh, that's 20 months. Uh, that was during COVID, of course. And 6 people in the world. Not the United States. 6 people in the world were documented to have died from misuse of
ivermectin. Uh, that's over a 2 month period, so that's 3.6 people per year in the world. Comparison uh compare that to 55 people that they have admitted and documented have died from the COVID vaccine. Uh, there's many more, but that's how many we've admitted to. 500, uh, that died in the US from As I'm sorry, Tylenol each year, 3000 that died from aspirin each
year and 16,000 that died from my favorite pain reliever, ibuprofen. Uh, so overall it's uh I'm not gonna tell you there's not any danger to it, just like there's, cause I wouldn't tell you there's any danger to ibuprofen. Uh, but overall it's being used and it's being used safely. The study that I handed out to you. Uh, is from the National Library of Medicine, wanted that there. And
What's both interesting and distressing to me. I I knew about this study in 2021. In Argentina, even though our government and authorities said there were no studies that showed that uh Ivermectin had any efficacy, uh, with COVID. Uh, I've got to meet with representatives of Google a couple of weeks ago, uh, where they admitted, uh, that they, how they had censored results and that, and thankfully, it
cost them a lot of business. And so they're, they're on an apology tour and um but it was distressing to me. That all this information was blacked out and keep in mind this is a, this is a study and it's one of many. You can read and they'll they'll talk about the other studies, and they were done not in the United States and places where they knew a vaccine would be available, but in places where they thought a vaccine might be available and they were trying other things to see how they might help. And so Just about 230.
Folks participated in this study, uh, 117, I believe in the uh experimental group or uh 92 in the experimental group, 117 in the control group. 77% of these were healthcare workers who had, uh, who were working directly with COVID patients. And you will see here now that we have this information available to us again. Uh, that if you turn to, it doesn't say page 4, but it's the 4th page
with the, you'll have a little tag on it. That of the experimental group, those who took COVID once a week. Mainly healthcare workers working with COVID patients 4 got COVID. And all, all were mild cases. That's the graph up at the top. It's written in the words, but just pictures worth 1000 words. Of the control group. 5th, uh, 25 who got COVID.
8 times as many. 15. Or moderate, 7 were mild, 3 were severe. And I'm not pushing ivermectin for COVID. I'm not pushing Ivermectin for anything. I'm just saying, uh, people are already using it. They're using it from ag stores rather than getting it from a pharmacy, uh, the latter, I think we all agree would be better, uh, already, you know what the dosage is, you know,
uh, there's no math to try to mix it up. And I think a more trusting I don't think I know, but I think it's the best way to put it. I'm more trusting of My Constituents And friends, common sense. than I am of the medical industry at the moment. Uh, and
of the government who told me that uh Throughout In fact, uh, even folks from local hospital, I called it horse paste. Uh, and, uh, it, there are probably all the things are people saying it worked for probably a lot of it, it doesn't do any good. It's like everything else that somebody thinks is a miracle drug, but it does a lot of good, uh, For some things and it does very little harm. Uh, it, I'm not gonna say it
does no harm because as I said, ibuprofen, uh, does harm. But I'd be happy to
answer any questions. Thank you. I would just say, Bro brush that, but
I know several physicians actually would Um Agree with your assessment. So that's, you know, um, Speaking of one who did a ton of research, uh, um, You know, I, I think it's just
want to be mindful of broad brushes, but I know I know I've spoken directly with physicians who prescribed a lot of different things to really help combat, uh, COVID and uh at that time and I think what you're saying is, I agree, and I, I'm supportive of your bill. I think at the time what was really frustrating not to relitigate what happened during COVID, but I think what was really, really challenging was there was no answer. And
So there were medical doctors because I saw it happen that got out every pharmacology book, every medical book, sat down for hours, did online research and to try to get exactly what that virus strain was, which was available online and did the work. They did the hard work to come up with the cocktail, so to speak, of medications that they knew was going to try to help save their patients' lives because 0 Nobody had an answer, and I saw
that happen firsthand with so many doctors in the state that really just said, I got to throw it out. I mean, there's no, there's nothing to tell us how to treat this illness, and I, but I got to treat my patients and um and they did such excellent work in my opinion, looking outside the box, and I think that's what you're testifying to here. Um, and just looking outside the box to come up with exactly what's going to understanding the symptoms, ing and testing what was happening in these patients and
then using their education and their experience and, and, and applying that, you know, to the medications that they also knew that would treat that specific symptom that may be found in a different type of an ailment, and it worked and I saw it firsthand work and but there was nothing out there. And so, uh, I appreciate the autonomy, uh, that happened in that because they realized, I got to do the homework, I got to do the math.
I got to do the science. I got to figure out how to treat this in order to save these people's lives because nobody has an answer right now. And so I got to see that firsthand and um, I agree with your bill and I agree with the autonomy, um, but it happened in the medical world too. I, that was my experience that I got to see firsthand. Sadly, you didn't get to see that experience for yourself, but you saw it in other citizens. But um, but I did get to see that. So just wanted to share that, but
are they quite senator Love, you have a question? I
Speaker 14
10:10
think you mentioned it. So Senator Clark is is Ivermectin, will we be the first state that that would actually Thank you for
Senator Alan Clark
Unverified
10:17
that question, Central Love. Uh, that's, I should have brought that out. We are the 2nd state, uh, this is actually we went and copied this from Tennessee. Uh, there are 7 or 8 other states that have it in their legislature right now. Texas is the last one that I know of last week that
Senator Fredrick J. Love
Unverified
10:37
introduced a bill. OK. And then, and so, so right now I guess. Even outside the country Ivermectin is is. Can it be in a dosage where for human consumption. Yes, it's especially South
Senator Alan Clark
Unverified
10:51
America and Africa, but all over the world, uh, it's used very broadly, especially for prevention of parasites. OK, and is, is it over the counter? In some places it is, some
Senator Fredrick J. Love
Unverified
11:02
places it's not. OK, so this is
not, this is not novel about, about, OK, alright, thank you. Senator Hill, you're recognized for
Senator Ricky Hill
Unverified
11:19
question. And Clark, he threw out some figures a while ago and said, I think it
was 2000 people died from Tylenol overdose or 500 from Tylenol. OK. And 6 from, from COVID or from, uh, From Ivermectin uh worldwide. What do you have any idea what the percentage of those are based off the number within the estimates to get us a percentage
to kind of put it more realistic because there's a lot more people taking Tylenol than it is I make
Senator Alan Clark
Unverified
11:45
them. Well, you might be surprised in some of these, these other places that there's more people taking over mectin than there are people taking Tylenol. Again, it's news to the US as of COVID, but this is a very broadly, uh, Distributed part of these third world countries and again because we know we knew that it was in fact it's it's won a Nobel Prize been called a miracle drug, uh, because how
well it does with parasites and we don't have as big a problem with parasites here as they do in third world countries. So no, I don't know the percentages, but I know that I said worldwide, but
again that that particular study, there were no deaths in the US OK, thank you, sir. Are there other questions from
members of the committee? See none. OK,
uh, anyone here to speak for or against this bill? See, OK, um,
If you, if you would like to come to the end of the table. Oh, you have a handout, OK. I didn't know
Speaker 33
12:51
if I was supposed to wait for my name to be called. I'm on the list. Oh, you are. Right Oh, OK.
What, OK, what's your name? My name is Brock Thompson. Oh, OK, we have you down for 169. OK. OK, if you'll just identify yourself for the record. Yes, ma'am. Brock Thompson.
Speaker 36
13:13
Current resident Arkansas citizen, OK. Go ahead. Thank you. Thank you, um, Senate Committee, thanks for allowing me to speak. I spent a little bit of time in the medical field, about 16 years in and out of the OR. Um, the purpose of my conversation today is to, yes, shed light a great conversations here um so far, and I thank you for that. Um, I want to take a little bit
of time and not much because I know that we're busy, but I also sent an email to all of the committee as well that's got 2 pages of reference that are cited for all the things that I'm going to speak about today. Also, I gave a handout that you should have that's really based on my comments. Um, Ira, Ivor Min is an FDA approved medicine primarily used for treating infectious such as river blindness, roundworm scabies, lice. It's got a long history of
safety use. Uh, this legislation is designed to have a positive impact on public health, providing affordable access to all Americans, especially those in rural counties. Um, Ivermectin is, is a new drug that many people have not heard of recently, but yet thousands of villagers across the communities gathered throughout most of the parts of Africa and Latin America know that it's name because it's been so prominent, Mr. Thompson, ma'am. I'm just gonna be real frank
with you. I think that Senator Clark has the votes to pass this bill. OK, ma'am. So do you want to just maybe Keep your comments super brief, of course. I don't mean to shut you down or anything. I just, I think the goal is understood,
Speaker 33
15:02
OK, yes, ma'am, um I, I appreciate the support and you have emails if
Speaker 36
15:06
you have any other questions, uh, my number's on there. I didn't answer any questions. Thank you. Thank you for being here and for your
time, Senator Clark. You recognize the clothes for your bill. Uh,
Senator Alan Clark
Unverified
15:21
thank you. uh. Madam Chair, members of the committee, I'm close. I appreciate a good vote. OK, motion to pass.
Second, all those in favor say aye and oppose. I have it. Congratulations, you've. Thank you, Madam Chair. Thank you, members
Senator Alan Clark
Unverified
15:34
of the committee. Thank you. OK, um, OK, we're gonna go straight down
this, uh, list, so I have, um, two bills I want to give the chair to Senator Wallace. Yes. Ma'am, you're recognized. Uh, thank you, um, I, I quickly
want to see if I can just go ahead and do the amendment for House Bill 1245, um, well, we'll, we'll go ahead and do 1182 while that amendment's being passed out. Um, Um, Senator Missy Irvin, District 24. I will do House Bill 11892.
I have Miss bunch bunch. It's all good, Rachel. Uh, with us, um,
House Bill 1192 is um a really critical and important bill for our uh long-term care industry, uh, it is, um, Just really, really important to define a certified medication assistance, uh, so that we're going to be consistent with what is happening at the federal level, this industry is highly regulated at both the federal and state level. Um, these certified medication assistance, um, are critical to their operation, um, and it's just, you know, if you have somebody
who is a loved one who's an elderly person, you know that you really need a lot of hands on deck to really help with, um, medication assistance. Uh, speaking just, I just want to say personally how important this is as I am personally in this situation with, with elderly parents and it becomes very, very challenging, um, just to get them to take their medication, um, I'm thankful today that we have medication that comes in pill form, patch
form, liquid form, um, it's, it's really, really critically important. They have invested a great deal into this program. Uh, the people in the industry have to set it up to make it functional, to make it work, to make it smart, um, and it's just really a big workforce issue for them, so I'm gonna turn it over to Mr. Mrs. Bunch and let her
tell more about the bill. Thank you. Uh, I know you have a lot on the agenda today. I'll be brief about this, but would you please introduce yourself, Rachel Bunch. I'm the director of the Arkansas Healthcare
Association. Thank you, ma'am. So the Arkansas Healthcare Association, we represent long term care post-acute facilities in the state, uh, medication assistants were recognized um somewhere around 20 years ago by the federal government and different states started to use them in nursing practice and long-term care. Um, thanks to some legislation that Senator Wallace helped us with back in the 2019 session, we updated some of our staffing statutes to reflect uh those new definitions and align with CMS. Medication
assistance. had been around for a long time, but not really used in our facilities. So we saw this as an opportunity with the workforce issues that we were seeing, uh, to add to our staffing, well, the shortage of nurses, but to also create a career ladder for people in our facilities. So the way that it, it kind of works, we have CNAs, then we have LPNs, RNs and the nurse practitioners, medical directors in every facility. This, these people fall between a CNA and an LPN. The existing CNAs who have worked in the facility.
in the past at least a year, but you'll see on our materials, the average is 10 years in the facilities and helping those CNAs go through a program to become certified as medication assistant allows them to do med pass. They don't do narcotics and other things, but regular meds, and it's really been a game changer for our facilities because it allows the nurses to focus on nursing tasks and work at the height of their license, and it allows these CNAs a career ladder. And you'll see, um, this attachment or a handout here with the blue on it. We've
actually started a medication assistant training program at our association sponsored by employers that are all across the state, our through our program, we've certified over 300 of these people that are, were current CNAs and nursing facilities, um, and you see there, the difference in the game changer that's made of the wages for those people and the opportunity, and we've now um are working on a new LPN program to help these medication assistants take the next step to LPN certification. So it's ultimately the main goal is always taking care of our
patients and providing care for them, and this allows those nurses to spend more time at the bedside, but it also allows a great career ladder for those people that are working in our facilities. Um, the, uh, the purpose of this bill, you'll see language here about cleaning up some definitions. We've had a lot of discussion about the definitions, but the two main things and why this is a scope bill and what we've talked about, um, this would allow those medication assistants after completing. Training, um, after completing training and skills checkoffs to administer routine insulin for
those uh those residents and respiratory treatments. Uh, that was something that other states have done, but when we started the program, we didn't want to add everything at once, so we started small and the program's gone really well and uh lots of facilities are utilizing them, and then this will be added
for them. I also just want to say it's incredible to see your private industry stepping up and and really attacking the problem on workforce. I mean, really, this model that they're doing needs to be replicated statewide in any industry. Industry and
private employers have got to invest, uh, in a partnership with us, um, in order to build the workforce that we really, really need to take care of, you know, of, of all the different industries standard level jobs that are out there. I mean, I think their model of what they've done here with their private investments and building this program is just a good model to replicate, to be honest with you. That's come outside of the bill, but, um, I just want to speak to that because it's smart and it's measured.
Members, are there any questions? Seeing none. Is there anybody here to speak for or against this bill? Seeing nonmembers. Is there any discussion? Represented love OK, I have a motion. Do I have a second? Uh, well, I have a second. All in favor say aye, aye.
Speaker 58
22:35
Congratulations, you've passed your bill. Thank you,
appreciate it. Thank you, members of the committee. Um, my second bill is a House Bill 1245, and it's just an amendment that I need to make. Um, I Uh, if that's OK, Mr. Chair. Yes, ma'am. Thank you, Mr. Chair. Um, House Bill 1245, uh, as you know, we had this on the Senate floor. There was a lot of discussion. There were some things that were pointed out, rightfully so, by Senator Johnson, Senator Sullivan, um, I've spoken to Senator Sullivan.
He's actually going to testify for this bill if it, uh, is amended and gets out of the committee, um, which I very much appreciate. So, um, part of the amendment is his language here on that fine and fees, uh, and we created um a very um distinct level that's defined, so it can't be um outside of any bounds. We kept, we kept that consistent with what we find in other areas. Um, also on page 2 lines 7. this isn't a licensing board, it's a registration. So
that was a change that we needed to make to clarify that and change license to registration. So, um, That was consistent with Representative Clowney, and we made that catch as well, so. I'd be happy to answer any questions on the amendment. Members, do you have
any questions? Seeing none. Do I have a motion? I have a motion. I have a second. All in favor say aye, ay. Congratulations. Thank you. And
then now we'd need a motion to pass a bill as amended. I have a motion in the
2nd. On a favor say aye. Go ahead, ma'am. Thank you. Thank you,
members of the committee. Yeah, 2 passes amended. stay in the chair.
judiciary, OK, we're right here, right? Yeah, your, uh, senator. I Uh, Senator Wallace, it's your bill. You can say you're going to pass over this bill here we've done all these.
Members of the next bill is my bill and I'm going to pass over that bill. And Senator Penzo, sir, are you ready to present Senate bill. 269.
Speaker 74
25:17
Uh and we're gonna do. No, it's We got a
bunch of people here. I traveled to be here.
I'm sorry, sir. Um, I'm moving on next to Senator Payton and his work on bills.
Speaker 81
26:10
Would you like to I thought we were in the afternoon. I can move. I'm, yeah, yeah, OK. Senator Payton, sir. Yeah.
Mr. Chair, so what do we do with 269? We're gonna do it this afternoon, sir. Let's move to this afternoon's agenda. OK, thank you. we want Oh, you're ready to do it now? OK,
members, we're now ready. We're going to do Senate Bill 269.
Senator Clint Penzo
Unverified
27:04
And so if you will introduce yourself. Thank you, Mr. Chair. Cenzo, District 31. Good
Speaker 89
27:10
morning, Mr. Chair. Casey Casselberry here on behalf
Senator Clint Penzo
Unverified
27:15
of Genesis Partners. Thank you, sir. Thank you. All right, so 44 years ago, I uh Iran legislation for for home care services, um, and kind of the reasoning behind that. My, you all know that my sister's quadriplegic, disabled, um, won't go through the whole story on that ALS.
Um, the, the company that was taking care of her. They, uh, didn't, didn't have the nursing staff to take care of her. Um, so I've spent a lot of nights, uh, taking care of
my sister, um, this was a frustration that went on for a really long time. We'd get staffing, lose staffing. Um And so I started looking for other companies, uh, reached outside uh found a, found a company, I believe it was in Mountain Home.
Um, and the, the coverage area. They were outside the coverage area. So I couldn't take care of my sister. They had the nursing staffing, but, but we were left without, without coverage. So, This kind of
got me interested in running the bill uh to expand the coverage area so that company could take care of my sister and found out that there was a lot of other people that were experiencing the same difficulties.
Um, this is really a big issue in rural Arkansas, you know, here I am in Springdale, one of the more populated, you know, I probably have one of the smallest districts, Senate districts in the state, and, and, uh We didn't have coverage
in Northwest Arkansas. For, for patients. So we had a company that could take care of her. So here we are. 4 years later, you know, there was stories about
this is end of the world, you know, this is going to mess things up.
Everything's fine. We have issues with
hospice, um, I was talking to a friend the other day and he was telling me that 4 individuals he knew couldn't get hospice care in Northeast Arkansas. When they
were You know, kind of in the, in the life stage. Um, and I think that's unacceptable. I think we ought to be able to expand the coverage area for the existing uh
providers in the state and And this bill does that. I'll, I'll let you continue on. Yeah,
Speaker 96
29:47
thank you, Senator Penzo. Again, Oh, little closer, that better.
Gene Eagle
Unverified
29:51
Thanks sir. Yeah, thank you, Senator Penzo. Senators, I appreciate the opportunity to address you very briefly on this bill. This bill really does two things. Number 1, it expands the geographic service area for hospice, uh, to make it consistent with home health and home care and all of
the other uh home and community-based services, uh, in Arkansas, uh, as Senator Penzo mentioned, uh, uh, this body passed a law back in 2021 to apply the same language to uh home health. services and that law has been in effect now for 4 years, and I think you'll find from the regulators and from those in the industry that the law has worked well and has, has not had any of the negative consequences that were uh that were paraded around
back when we were trying to pass that bill in 2021. The second thing this bill does is add some language in the in the second section to address some concerns. That the Department of Health had and that the health service is permitting agency had uh as a result of that 2021 uh bill. So it uh it takes care of uh the reporting requirements so that the agencies know which which services are being uh uh
provided in, in which different geographic areas of the state. Um, this bill provides choice. That is what uh we believe that uh that the 2021 bill did with respect. To uh home health, and that's what we believe this bill will do, uh, with respect to hospice. Um, we've heard some arguments that have been made against uh this bill. I'd like to address those for you briefly. They've said we've heard that some will say that this bill will drive out good providers
from uh areas that already have a good hospice provider. Uh, we've heard that this will lead to worse care. Those are the identical arguments that we heard in 2021 with respect to uh Act 817 that expanded the geographic service area, uh, with respect to home health that is not borne out in the four years since that bill became law and we believe that the same would hold true with this. Bill with respect to hospice. We've heard that uh this bill
would lead to a reduction in care in rural areas. Again, that's that's another argument that was made back in 2021 and has not borne out in the subsequent years. I think it's important to point out as well that uh if you are granted a license for a specific area under a permit of approval, you have to provide services in that area, uh, or risk losing your license even if you are able to branch out into other areas pursuant to the geographic service area
expansion uh in this law. We, again, we heard these, these arguments, uh, in, in 2021 and they've not borne out in practice. So we believe that this bill is is necessary, it's helpful to provide services throughout Arkansas and to provide the citizens of Arkansas, uh, with the palliative care, uh, end of life care that they deserve and give them choices in uh in making that decision. So with that, I'd be happy to answer any
questions, but we would ask that, uh, we would ask for your vote. In favor of this bill. I'm sorry. Senator Hill. OK, looking at
Senator Ricky Hill
Unverified
33:28
your uh geographics here, you're showing that expanding 100 miles. Yes, sir. If you, uh, put a steak right here in Little Rock and
you go the right way the crow flies. You're covering almost the entire state. That's true. Yes, sir. So why didn't you just say I want to open it up to everyone for the
entire state instead of, you know, that way, that's just a sneaky way of trying to do it, is it not? I
Gene Eagle
Unverified
33:49
don't think it's sneaky, Senator. Have you drawn it
Senator Ricky Hill
Unverified
33:51
out and checked how far it really goes just to
Gene Eagle
Unverified
33:53
be clear, there's no question, you're right, this would cover the entire state. And that's what's happened in home health. If you have, if you have a, uh, if you have a, a, an agency at any point in the state, you can effectively cover the entire state. One reason we didn't want to do it like home care, which allows a statewide Liener and we wanted to do it like home health is by doing it
this way, each time you open a new branch, uh, there's an application process that is required, which includes a fee of $3000 for each application, which helps cover the administrative costs that are going to be necessary in order to implement this bill. OK, thank you. Yes, sir. Members, are there any other questions? See now, no,
I'm now going to go down to the for and against. Speak against the bill.
Is Mrs. Katherine Grubbs. Ma'am, if
you will announce yourself. Yes, thank you.
Speaker 76
35:03
Good morning. OK. All right, is it on now? OK, thank you all for your time this morning. Uh, my name is Katherine
Katherine Grubbs
Unverified
35:12
Grubbs, and I serve as CEO for Circle of Life Hospice,
based in Springdale, Arkansas and I'm here today to strongly opposed
ma'am, I'm so sorry. Please speak up. Some of us like myself and Central Hill are a
Katherine Grubbs
Unverified
35:31
little hard hearing. OK, OK, I'm sorry. OK, can you hear me now? Yes, ma'am. Thank you for being here. OK, once again, my name is Katherine Grubbs, and I'm honored. to serve as CEO for Circle of Life Hospice, based in Springdale, Arkansas, and I'm here to strongly oppose Senate Bill 269 and its related
amendment. This bill threatens the quality, accessibility, and sustainability of hospice care in Arkansas. If passed, this bill would basically dismantle the existing Arkansas permit of approval process that ensures hospice services are distributed appropriately across both urban and rural areas of the state. And I believe there are some handouts, um, that we have for you all that actually has a map that shows the hospice coverage within the state.
The existing process exists to protect access to high quality, sustainable hospice care for all Arkansas, and it works. Consider this. Arkansas hospice providers rank significantly higher in quality of care than national averages. Compare that to steaks like California that were that were unchecked expansion has led to lower quality of care and extensive fraud and abuse of the system. Our current system works and
this bill seeks to undermine it. If approved, SB 269 would also drive up health care costs by allowing unnecessary and duplicative expansion. Stretch an already limited healthcare workforce, even thinner, making it harder for hospices to recruit and retain staff. And it would also burden taxpayers with the cost of more state auditors that oversee, would oversee the influx of these extra providers in markets.
It's also incredibly concerning that this bill would allow hospice agencies to expand service areas by 100 miles. From a new, any new location. In Arkansas, 100 miles can mean more than 2 hours of travel time. Now imagine your loved one. Suffering from uncontrolled pain or difficulty breathing, waiting 2 hours for care. Would you accept that? I certainly wouldn't.
This bill prioritizes expansion over patient care. It sacrifices quantity for quality. And it places profit over people. It was said in the previous presentation that the home care expansion has been effective, but I would disagree with that as well. For the sake of Arkansas families, I urge you all to please vote no on SB 269. I'll be happy to answer any questions you might have.
Senator Scott Flippo
Unverified
38:32
Center flippo, you'll recognize, sir. Thank you, Mr. Chairman. Ms. Crow, can you explain to me just a little bit more detail the profit over the people part of
Speaker 120
38:41
this and how that works. Well, there's no doubt that if this bill were to
Katherine Grubbs
Unverified
38:45
pass that providers would gravitate towards urban areas. The fact is care is a lot less expensive to provide, where there's more population density, you don't have as much travel time for caregivers, and you don't have to pay them as much by the hour to travel to see patients. So it's much less.
Less expensive and you can have a more positive profit margin if you're in urban areas, OK, and I
Speaker 123
39:07
appreciate that. So just to clarify that it's not that it's not a matter of like the quality of the care of
Senator Scott Flippo
Unverified
39:12
the services that are being provided. It's just the incentives in your opinion, that would be motivating people to go to more urban areas where there's a higher higher population base,
Katherine Grubbs
Unverified
39:18
right? And then that would, that would create more duplication of services in areas that don't need additional hospices in their areas based on the current certificate of need process. Does the market not just work that out like and I have to say one of our board
members made a great analogy. He said healthcare is not the same as selling hamburgers. If you add more providers with the same service, it does not drive down costs and drive up quality when it comes to medical care. It actually does the opposite. You lose economies of scale when you have a bunch of competitors come into the market, and it does not improve quality. It's been proven time and time again, and there's a reason that 35 other states have certificate of need in place that does limit expansion of healthcare organizations because the data shows that it works.
Senator Scott Flippo
Unverified
40:06
OK, but again, just to get back to it, that the issues are going to be like the motivation to expand into more urban areas and more, you know, larger population areas and not necessarily to say that a person providing services is just, you know, you know, services equate reimbursements for Medicare, correct? So for-profit, nonprofit, that's how this all works. So this motivations for, you know, you know, you know, the hospice in Springdale would be the same for the hospice in Mountain home, the same for the hospice in Dewitt, the for the hospice in Jonesboro,
the same for the hospice and Little Rock. You provide services. You bill Medicare for these services, and, you know, generally patients should have, you know, the option or the choices to go to whatever provider they so choose, but as far as these services, Medicare has certain rules and restrictions that you have to meet certain criteria. And if you're flagged with fraud or anything, then that throws in a red flag. So as far as the services being provided to the individual receiving the care. It works the same way in a nonprofit as it does
Speaker 129
41:03
in a for-profit for the most part. OK, thank you. OK.
Senator Hill, you'll recognize her. Thank you, Mr. Chair. I want to
Senator Ricky Hill
Unverified
41:17
go back to something Senator Penzo said a while ago whenever he was presenting his bill that he had some issues out of Springdale, Arkansas if I'm. I'm not mistaken, I heard you say you're from the Springdale, Arkansas area. Is that correct? Can you allude to what he was,
uh, talking about a while ago. Can you comment on that or y'all, do y'all not have the services available there that's needed to hospice care, what he was referring to was home health,
Katherine Grubbs
Unverified
41:38
um, hospice is quite different in the way the service is provided as well as the
regulations that we operate by, so I can't speak to his experience with home health, but I can tell you as far as if you look at what is referred to as the bed needed book by The um permit agency, we are very well covered in the Springdale area for hospice, and I can tell you anyone who is referred to us to receive hospice care, gets it. Are you familiar with the
Senator Ricky Hill
Unverified
42:05
Jonesboro area that he mentioned as well. hospice, but if you do
Katherine Grubbs
Unverified
42:10
look at the map that we provided, you
can see the coverage area for the number of hospices within each county, and it really does show excellent coverage in almost every area of the state. There are only 1 or 2 counties that only have 1 or 2 providers, and they're very rural. OK, thanks for that. Yes, and I know especially in the area where I'm at, and one of the providers
Senator Ricky Hill
Unverified
42:27
for my family is actually in this room right now, and I think they did one hell of a job. Thank you. Thank you. Senator Love, you'll recognize her. Thank you. And I want to follow
Senator Fredrick J. Love
Unverified
42:44
up with Senator Hill's, um. Question, what, what, and I'm just curious, what's the protocol? So say for instance, somebody doesn't receive. The hospice care that uh they feel that they deserve. Do you all have a protocol for that? I mean, who do you report that to? I mean, well, anybody that has any issue with their
Katherine Grubbs
Unverified
43:05
care, there's, there's a phone number we all have to post on our websites that they can call it and it gets to the Arkansas Department of Health that would come out
and investigate, um, more than likely we're able to resolve any issues related to, to care and No, I'm just, I, I was
Senator Fredrick J. Love
Unverified
43:24
just, I'm just curious in regards to if there's an organization, so you're saying the Arkansas Department of Health if an issue like that, um, Came about in the Arkansas Department of Health would have those numbers. As far as complaints, yes sir. OK, all
right, thank you. I'll ask Arkansas Department of Hell. Thank you.
Members, are there any other questions of this witness? See none, ma'am, thank you for being here today. Thank you all for your time. that are different.
OK. Speaking for the bill. Uh, Brock Thompson. you. I'm sorry, Bill Winfield. OK. Speaking
against the bill Doctor Bill, Brian Bill.
Speaker 153
44:55
Good morning. to, if you will introduce yourself, sir sir. Yeah, my name's Brian Bell. I'm the chief medical officer for Arkansas
Chair
Unverified
45:05
Hospice. We provide services all across the state, rural areas, Little Rock from Beville all the way down to Monticello. I'm a board certified hospice and palliative medicine physician, and I'm a fellow of the American Academy of Hospice and Palliative Medicine. And I grew up here in Arkansas. I went to med school, UCA, Hall High, uh, and left here several
years ago and came back here in 2016, uh, from South Carolina and Spartanburg, South Carolina, where I was working and, and the main reason Besides personal, professionally, I want to make sure that we had great hospice and palliative care in our state. That was from my reasoning, my purpose, my why, why I came back. And I'd experienced bad care when I was in Spartanburg, uh, Spartanburg is a town about the size of Jonesboro. There were 37 hospices in that town that size.
And at that time I was working as a palliative care physician in the hospital, and so, uh, at least 2 to 3 times a week, I'd get a call from the emergency room, the hospital, the hospital is saying, you know, you got one of your hospice patients here, why are they in the hospital? Because most of the time hospice patients stay at home. They want to be at their home, whether that's A nursing facility in ALF, and so invariably I would go see them those 2 or 3 times a week, and I would talk to them and say, you know, how's it going? I go, it's not going good. And that was not my hospice, 99%,
90% of the time it was not my hospice. It was one of the others 36 hospices, and they would tell me about the poor care they were receiving, uh, that they weren't getting the help, and they really wanted to die at home, but the hospice wasn't providing the care to do that, so they had to come to the hospital and eventually a lot of times they would. at home and sometimes I would put them on my hospice and so My reason for coming back was to make sure things like that did not happen in our state. And so this bill passes, I'm going to give you two scenarios that I
can definitely see happening with this. So scenario one, you're a hospice provider in Fordyce, Arkansas. Doing a great job. Now you suddenly expanded your area 100 mile radius or 200 miles across. It's 2 o'clock in the morning. You get a call from Lake Village, which is now is in your service area saying mama's short of breath. Mama can't breathe And this person is panicking.
And they don't know what to do. And so, The person from that hospice says we have 2 on-call persons on call, but guess what? They're in Texarkana, and they're in Cersei right now. If you Google map that to get to Texarkana Lake Village. It's 3 hours and 14 minutes to get from Cersei. To Lake Village. It's uh 22 hours and 47 minutes, so 3, 3.5 hours, they may have to wait to
get care. That's a long time. We think in hour is a long time, but 3 hours to watch your mother. Suffer. It's really not acceptable. Scenario number 2. You're in calico Rock. You're a hospice provider. Suddenly and doing great rural care and as Catherine said, it is more expensive. We operate in rural areas, we operate in urban areas, and it is more expensive for us to provide care. I'll be honest with you, sometimes we we our rural offices and we have
multiple rural offices. We don't even make money in those offices sometimes, but we're committed to provide that care there because we feel like it's the right thing to do because it is more expensive, but this calico rock office now says they're looking at that 100 mile radius. Guess what now? in their radius. Springdale, Rogers, Fayetteville, Little Rock, Jonesboro. And they say, gosh, it's very expensive to provide this care in calico Rock. I'm gonna move to Little Rock. I'm gonna move
to Jonesboro where I can have more patients, more care. Right. So what happens then, so now that group says, you know, I don't want to spend any more time in calico Rock. I'm just going to spend the time where it's more profitable. And so they move and guess what? Now we have a desert for rural care, for hospice care. So there's a desert. Going back to my previous example. The difference between home health and hospice when I talk about on call, when you call home health at 3 o'clock in
the morning, uh, and that's why I'm trying to make the difference between the previous bill about home health and the bill about hospice. When you call hospice at 3 o'clock, home health at 3 o'clock in the morning, you'retress that home health nurses go to the emergency room. OK. When you call hospice, we say we'll be there. physically be there. Someone will be at your door. Hopefully within an hour, hopefully within 30 minutes, not 3 hours. OK.
So as we take a look at this bill, you know, I, I really I want you to consider these things as you're discussing in this bill, you know, when hospice is really good. We're about Mediting or mitigating suffering. When we're great, we're about eliminating suffering. This bill here, in my opinion will be about propagating suffering. I think there will be worse quality, OK?
And we'll have patients suffer if this bill passes, and so I do want you to think about that, and I think these are, this is what I've been doing for 19 years. I have worked in areas where unregulated hospices. are in place and the care is not great in the states that have done that actually now like California and Texas are uh there was a special focus group to focus on 50 hospices that kind of backed out on that. But most of those hospices that were in this special focus group who
were providing possibly fraudulent care, and they didn't do it. We're in these states, most states that did not have a great permit of approval. So I do want you to think about that as you're second about this vote, about the quality of care. So that's all
Senator Clint Penzo
Unverified
51:30
I have, Senator, Senator Pins though, you recognizer. Thank you, Mr. Chair. So, You know, we're, we're talking about
protectionism versus competition here, um, can, can you move your office? You, you were talking about if,
if this radius is expanded, they're gonna move their office into the new area,
Speaker 163
51:49
they you can move your office right now, yeah, you could move your office, uh, if you, so the
Chair
Unverified
51:55
answer, the 4 dice I guess saying you couldn't, you know, move an office. I think the more problem I think is about the on-call issues, which is what the on call being on call. 24/7. I mean, we're on call Christmas and so it's expensive on call is always an expensive thing on hospice because unlike home health, you know, you just tell the person to go to the emergency room, our role in hospice is to make them. So yes,
we could move our office and if you were in Fort Ice, you could move an office, but that also gets more expensive to have multiple offices covering the same area. The example I was giving more about the, like I said, the on-call issues, which means, you know, you can't have You would have to hire a lot of nurses to be on call and that becomes just financially, kind of not financially possible a lot of times when you have this big service area like this, but yes, you could move it. OK. So, so do all of you, you
Senator Clint Penzo
Unverified
52:50
mentioned calico rock, um, do all of your employees work in Calico
Chair
Unverified
52:55
Rock? we're not, not in calico Rock. I just kind of gave that example because what it said, but we have offices in, you know, uh, Monticello and, and Batesville and things like
Senator Clint Penzo
Unverified
53:05
that. Do all your employees live in Batesville or Monticello, where they scattered around your
Chair
Unverified
53:10
coverage area, they could be discovered around the coverage area. OK, so some
Senator Clint Penzo
Unverified
53:14
of them might be today. miles away from a patient within a 50 mile coverage area, right?
Chair
Unverified
53:22
You know, I'd say with us particularly no, because we have actually sometimes even limited our coverage areas so that we can cover with our hospital because we
Speaker 169
53:30
do have some overlapping with some of our licenses that we have and so many lessons do you have? We have 4 different licenses. OK, OK. Well, we had different offices within some of those licenses, so, uh, obviously our Little Rock office will have a, you know, under that license, you know, have a Little Rock office and a Hot Springs office as
Speaker 167
53:53
well, and Jerry is a lot bigger than a 50
Speaker 169
53:56
mile radius currently. It is with the license, but our offices that we have moved those uh offices there to be to make that smaller because we've committed, it's more expensive if I'll be honest with us to do
Chair
Unverified
54:08
that, to have that, but we, to provide that care, we'd say, all right, we need to be, um, you know, in this area with an office and pay for that office and pay for the staff there, hopefully everybody would commit to doing that. It's not always a requirement to do that, right?
Senator Clint Penzo
Unverified
54:25
scenario with calico rock is an office and you were talking about. Being able to cover people in Northwest Arkansas, um. I mean, would all of your employees have to drive from Calico Rock to Northwest Arkansas,
Speaker 172
54:37
or would you have employees in Northwest Arkansas that worked on the perimeter of that, I
Chair
Unverified
54:42
think you would have employees there. For me, that example is meaning you would quit operating in Calico Rock. You just not even have employees or even an office in Calico Rock necessarily because it is so
from a uh uh a population density, you would migrate obviously to these higher densities and then you would basically desert calico Rock and just say, hey, we just want offices in Springdale. We just want offices in Jonesboro. We just want offices in Little Rock and we're just getting out of calico rock altogether and not because it's just too expensive to provide care there and we're just going to provide care in these high density areas where it's the cost of providing care is lower, and that's why I was trying to say that you would leapfrog. A small rural office, let's say
in Lake Village, with leapfrog itself to areas where the density is higher and abandon their original license area that was there because they can move 100 miles, and to me that's why I say I think what we're going to have now in the rural areas is a hospice desert where we don't may not have providers because everybody wants to get to the Little Rocks, Jonesboros. Well I guess, I guess I've got a question. You
Senator Clint Penzo
Unverified
55:56
said that you're afraid they're the providers are
going to abandon rural Arkansas, you, you have 4 offices that you have a 50 mile radius around. Do you currently neglect rural Arkansas? I mean, you, because you have a much bigger with 4 offices you cover most of the state, right, right, and so we don't, it's not for all of
Chair
Unverified
56:18
our licenses are not 50 miles, so on our baseball office, some licenses, and this is weird, some licenses only per county. So we have per county. So our baseball office only covers 2 counties, not even a 50 mile radius that
we have there, so, um, so each every license we have some of that 50 miles, some have just the county that's before my time as part of the permit of approval. But here's the thing, I have offices where I'll be honest with you some months I don't make money in those we lose money, but here's the thing in Little Rock, I make money. Which offsets what I can provide up there, OK? And so this is what happens is, and it's a
commitment to my mission that I get to do this because I say, all right, I make money in Little Rock. I lose money and say I'm just gonna a bearable office. We do it day in, day out. But we want to be able to provide that care. Now, here's what what my opinion, what would happen. Have wain now providers. If you can look at that map, there's probably 5 to 10 providers almost every county in the state, so there's plenty of coverage. But now all 20 in Little Rock. They have eat into my business, OK? They have
chipped away at my profits, which were not for profit, but that we still have to make profits, but That money that I make here in Little Rock. Offsets what I lose in varyville, OK? Then I have to make a very difficult decision. If I want to keep providing care. I may have to shut my office down in Beville, OK, because I can't afford because I've lost the money in Little Rock this morning and I can't offset those calls, and we do that a lot of our smaller offices we operate.
Because we can make money in one place. So that we can offset the cost of losses we're doing in those rural areas, and we're going to commit to Arkansas hospice is going to commit to rural areas. We want to be there. But this could endanger how much care that I could provide there because I do, I am afraid because I've been there, I've been to South Carolina, I saw it. I mean, there was 37 hospices in in Spartanburg County in Spartanburg. Would you go out 2030 miles from there. It was, it started to become a desert. You couldn't
find hospice care because those hospices didn't want to go to rural areas. They wanted to be in Spartanburg, Columbia, Charleston, you know, where there were, you know, large population densities. So Center Hill, sir, you are recognized. Mr. Going
back to what we were just kind of talking
Senator Ricky Hill
Unverified
58:56
about a while ago. It sounds to me like uh one of the key components that's being left out is the employees you have on call to make that distance drive that they could
be in Cersei instead of in Monticello or Lake Village or wherever. It's who's on call that night where they had to travel from. It could be someone that's in. Calico Rock has to drive to Little Rock, right, right, right, right. In that time frame and as someone who has been there and seen their mother and father suffer and make that phone call that you're referring to a while ago on a day that had snow and ice on the ground and had someone there less than an hour. That's a big, that's a big deal
to me because I've actually been to where you were talking about a while ago seeing mama and dad suffer, so with that being said, I've been there and I don't want a vehicle having to drive 3 hours from Springdale, Arkansas to Cabot, Arkansas to take care of someone.
Chair
Unverified
59:54
I mean 200 miles. It's a 10 mile radius, but it could be 200 miles and you can't afford to staff a hospice like you do in the daytime and we're open 24/7, 365. You call us. Christmas morning at 3 o'clock.
We're gonna come see you. And that's, and that's, I think that is the difference between the hospice and the home health bill. There is different rules and regulations, different and different philosophies, I guess, of care. I mean, I always say this in hospice. We get one chance. There's no dress rehearsal for dying. OK? We don't get it right. You have left a family, and we've had studies that show PTSD. If you can't get it right, they die miserably and, and if we needlessly cause suffering,
which I think this bill will cause needless suffering. They're going to suffer for that for the rest of their life. They're watching their mama not breathing, not getting the help. And that's the difference between home health and hospice. I know we want to talk about the home health. What happened 4 years ago. But these are not Comparing the same things. These are apples and oranges, OK? Have you seen any data to back up
Senator Ricky Hill
Unverified
1:01:01
what they're saying more, more services are needed on this. Have you seen any data to say it is for hospice,
Chair
Unverified
1:01:10
no, I mean, that's why we have the permanent approval. They look at that. You can look at that map. It's
Speaker 184
1:01:15
mostly green. Yes, I'll say that if you've seen any data showing the sites you've been in the business so
Chair
Unverified
1:01:20
long, you know, I've been doing this. I think we have a, and I came here back in 2016 to make sure that we've, I've seen improvement year after year in the hospice and palliative care world. This coverage is an excellent service. Yes, there's one or two counties that may only have one hospice and maybe we can go through the permit of approval process and get it, like Ashley
County is the only one with one, so maybe we need to go in and and get a permit of approval to go in there, even though it, when you look at the the absolutely numbers that we need that says no, we don't need two hospices in this county, but I do feel like it's all right to give a choice, like, you know, so there's ways to remedy this, but when you look at this map, there's Shortage of quality hospice providers in our state that will take care of patients. We mostly admit patients on the same day. We go see someone, we're going
to take care of you there. You know, you call me at, you know, 10 o'clock, 11 o'clock in the morning. I'm gonna be there at 1 o'clock in the afternoon. More than likely I'm going to have you admitted by 2 o'clock. That's how fast. And I will tell you, I know the other hospices, Catherine and, and other people that may speak today, they're going to be there because the average time for a hospice patient medianly Length of stay is 13 days. That's how long a patient lives on hospice 13 days. So 50% will die within 13 days.
You don't want to delay getting to see someone because if you wait a week, you may only have 3 or 4 days or you've probably already missed, uh, missed that already, so hospices in general and all the hospices that will speak with you, we're about getting there, taking care of the patients fast. I've never turned down, you know, an appropriate hospice patient. We all have the mission in life to take care of patients at the end of. life. And we're going to get those patients admitted quickly.
Appreciate it. Thank you for what you do. So flippo, sir, you
Speaker 188
1:03:19
are recognized. Thank you, Mr. Chairman. Dr. Bill, who owns the permits? Are you a
Senator Scott Flippo
Unverified
1:03:24
for-profit, nonprofit, not, not for profit, not for profit. So all your permits are under not for profit, right? Yes, OK, OK. So I want to go into Izard County, which is in my district, um. Community Medical Center of Vizard County. You know who that's owned by. That permit is owned by, I don't know. No, sir. Boa Vita Healthcare, a
subsidiary of Americare Holdings. Do you know about Americare? I don't know. I don't either. I know Greg Wood at Hospice of the Ozarks. I know I can call Greg. I see the, the hey buddy, hey buddy, phenomenal job you all do. Now I want to I want to pick on a few things we're having a fair conversation here because this is a conversation's not an argument. There's, you know, two sides to a coin. Um, not all. I've got a small assisted living facility right outside of Mountain Home, and Greg and I've worked closely over the years and just phenomenal collaborative partnership to the point where I only want to sign
a contract with other hospital providers because like I just You know, when you, when you, when you
Speaker 182
1:04:17
got, when you got gold, that's, you know, I'm not looking to exchange it for silver or the possibility of silver, and I feel that way about
Speaker 188
1:04:22
the Ozarks, but with that, a lot of my residents, they're going
Speaker 129
1:04:26
to be on there for a year plus. They don't just die within 2 weeks, OK, so I want to make very clear you can throw out a number and this and that, but like a lot of these people, they're not just going in for the last 3 months of life. They might be on there for 33 weeks, 3 months or 3 years. No, you're
correct. Yes, sir. So, you know, when you talk about
Senator Scott Flippo
Unverified
1:04:46
real health care, I 100% get. I remember we had an issue with preferred family healthcare years ago doing behavioral health Medicare providers specifically for children, but they would take over parts of the state that we would have struggle to get
Speaker 129
1:04:56
other providers in, and I Because they were money losing parts of the state, but they've got these other contracts that kind of were able to offset that, so I do understand that that narrative, but I want to hit on who are the permit holders in parts of rural Arkansas. In Stone County, you have
kindred Hospital or kindred hospice owned by Clayton Due and Rice Private Equity and Humana. You've got hospice home care is owned by Bright Springs Health Services, Bright Springs Health Services is owned by the following, you know, KKR and company Inc. private equity, Walgreens Boots Alliance, Fidelity Management Alliance burstein LP private equity. I mean, are these people in it to lose to lose money because
they're providing their permit holders in rural Arkansas right
Chair
Unverified
1:05:46
now. Sure, sure. I don't think parts of it in my area, right, right I don't want any hospice to lose money, you know, and I can't speak for those hospices, you
Speaker 188
1:05:55
know, you know, you could say like everybody's got to make money. I don't know this, does Medicare bill do they reimburse at a different level from for-profit to nonprofit. It's the same. Yeah,
Chair
Unverified
1:06:05
yeah, here's the thing with, with Medicare, you get paid the same, there may be some little variation in the kind of but you paid the same whether you do a
great job or a bad job. You get the same um amount of money per day. We operate on what we call a per diem of fee. So, uh, so yes, sir. And you know, again, my thing
Jason Hatfield
Unverified
1:06:25
is like I, I like to know who the operators are in
Senator Scott Flippo
Unverified
1:06:29
the state. So if I've got a constituent that's got an issue, but I look at the permit holders, you know, of some of the, the, the, the hospital providers in my area. I don't know anybody at Humana.
Speaker 195
1:06:40
I don't know anybody, you know, you know,
Senator Scott Flippo
Unverified
1:06:42
UnitedHealthcare. I don't know anybody at Walgreens.
Speaker 129
1:06:46
I mean, full disclosure, my grandfather did used to put up some signs for them back in the early 80s, but he's deceased and so that was my only link to Walgreens, but I don't know who these people are, but you're sitting here kind of advocating on their behalf. Sure, sure. And I'm going
Speaker 188
1:07:00
to make an argument that theirs is not just in it, so we can like provide care and break even. Sure, sure, private equities holdings that I've ever, as I said, I once again, Senator Flipper, you know me, so you can call me, right, so we right down the road here. Greg, you know.
You know he's a little bit closer. I appreciate what you're saying, but I think that it's important that, you know, like we don't muddle the waters here. I think, you know, it's everybody's going to cherry pick the
Speaker 129
1:07:27
narrative also their respective case. It's our collective responsibility as members of this committee to be able to see through that and to look at each of the merits of each argument for or against, and then make a decision that we feel right is for, you know, for the people here in Arkansas. Appreciate your testimony, Dr. Bell. You know, don't don't know your first time meeting you. I know you care. I can tell you
care about your patients, but in all of this, You know what it is bill passes or fails, the fundamental responsibilities, I don't think anybody in this room, not in the crowd, not at this table, wants to see people struggling at the end of life receiving good quality care. That is, there's, there's a disincentive to every one of us across the board because we all have family, we all have parents, grandparents ourselves, a child, a sibling that's going to need these services and not one single person stands to benefit if we see those diluted. Thank you, Mr. Chairman.
Thank you, doctor. Thank you Senator Penzo, sir, you're
recognized. OK. Members, are there any other questions for the witness?
See none, sir. Thank you for your testimony. You are dismissed. Thank you, senators. Ms. Black, Melinda Black.
Speaker 200
1:08:56
Hi, I'm Black. Uh, first off, thank you, senators for the dedication to the state of Arkansas and allowing me to speak with you today. I am privileged to work for the nation's largest hospice provider. Uh, we're also the largest in the state of Arkansas. Uh, I also covered the states of Texas and Louisiana. Admittedly it could be argued that my organization stands to benefit from SB 269.
And while that point could be made, I'm here today in solidarity with my fellow hospice providers. Speaking as both a representative from my company and as a hospice family member. I have not done a lot of things well in my life. For example, I and my mom's 2nd favorite daughter, and I would like that on the record, please. Um, but if there's one thing that is true, I can say that hospice is my calling. I had been a home health
administrator. I had been a nursing home administrator, and I can tell you that hospice is not the same care delivery model. Because of that, I feel a sense of obligation to speak out in opposition of SB 269. Saying that, I asked that you indulge me for just a second. I want you to think back to when your child was born. I'm sure that
Speaker 203
1:10:17
you have a visceral memory of that moment. I will tell you I have a funny
Speaker 204
1:10:26
experience where I remember my nurse speaking about fish sticks. Now I ask
Speaker 200
1:10:31
that you think about the time that you lost someone that was beloved to you. I'm sure you also have a visceral memory response. If I asked you, you could probably tell me whether that loved one died peacefully or not? You could tell me whether they had the care and attention that they needed at the end of their life. This is the space that hospice occupies and it's sacred.
As hospice providers, quality care is central to our business model, and care must be measured, analyzed, reviewed regularly to ensure that we are doing it right. A quality hospice agency can tell you how often their nurses are seeing patients each week on average. They understand that the most intense needs of families is at the beginning of hospice and at the end of hospice, they can tell you what the average visits are in the last week of life. A quality hospice agency has nurses trained to tell the difference between terminal
delirium and terminal agitation. They can prevent a 911 call in the middle of the night. A quality hospice agency can tell you when a patient revokes hospice, they will investigate it. They will review any concerns about care and they will take those concerns seriously. They never want to sell a family member or a patient as they only get one opportunity to make it right and they want to make that a positive visceral memory.
Medicare provides guidelines for hospice so that when bad actors enter the hospice space. Whether it be from cost cutting or lack of staff, you will often see visit frequency, be the first indicator of quality decline. Medicare only requires that an RN visit once every 14 days. And in other states, such as in Texas, Louisiana, California. It's not uncommon that this becomes a common practice. For a family who just brought home their 85 year old mother
from the hospital, uh, with a massive stroke. This becomes anxiety producing for the family. It provides very little support as nursing is minimal and the ancillary support services such as the chaplain and social worker that is needed for the family. They're in survival mode and they're unable to see the benefit of these services. In these states, not only is there a nursing shortage, there's also usually a CNA shortage as well. So instead of receiving CNA visits 3 times a week or 5 times a week, they may only get once or twice a week.
This leaves the family feeling overwhelmed and feeling like hospice really doesn't do anything. You may have nurses who do not understand symptom management, and they don't realize that while comfort medications such as morphine and Ativan have a place in hospice. Oftentimes they started immediately and they become a surrogate for quality nursing visits and rather than address root cause of patient symptoms, Those comfort medications are given in the stigma of hospice medicating patients to death is further.
You will have agencies that will take a broad liberty in determining what qualifies a patient for hospice. For example, in Texas, you will have agencies that will allow patients to both be in a nursing home receiving rehab services as well was also receiving hospice services. This is essentially double dipping into Medicare. This erodes what hospice actually is. It confuses the message to patients and families, and it is the literal definition of fraud, waste, and abuse.
Or you may have an agency that admits and bills for services, but the patient has never really seen and medications are simply refilled, and yet the Medicare system is billed as though the nursing care is provided. We have advanced hospice utilization in the state of Arkansas to 48.7%. As our population ages, the need for hospice will increase. We will need to scale and allow more providers to service patients in this area. There is a process that is currently in
Speaker 206
1:14:34
place that works and it allows for us to still maintain a degree of quality control over the care
Speaker 200
1:14:42
that is provided. States without controls for how hospices are started. And certified have seen an increase in fraud to the point that many have issued moratoriums on new licenses and many states have pressured Medicare to prevent new hospice startups. Louisiana currently has such a moratorium in place. California also has a moratorium. And also one of the highest rates for fraud in the country.
Once a license is granted to an agency, oversight is limited as a survey is only conducted once every 3 years. In Louisiana, for example, it is not uncommon for a hospice agency to open up and to close before they ever receive a survey. And in the interim they receive hefty Medicare funds without any oversight. For a
Speaker 206
1:15:27
hospice agency that wants to do it right, we celebrate the positive feedback. Hospice is an area of healthcare where empathy and compassion
must match the level of care. You only have one opportunity to do it right. For every organization you are hearing from today, the times we do not get it right, we lose sleep. Quality improvement measuring the quality of the care that we provide
Speaker 200
1:15:53
to our patients and families and their experience with our agency is first and foremost, our lead measure to success. It is which everything else is derived. Just
Speaker 206
1:16:01
like I asked some of you to remember the times someone beloved to you passed.
Speaker 210
1:16:09
Family members remem remember those experiences for the remainder of their life. So whether it was
Speaker 206
1:16:15
Misty Pratt from Arkansas Hospice, who sat with me when I lost my dad to pancreatic cancer. Or Margaret Love from UAMS palliative Care who stayed with my mother-in-law during COVID because no one could be with her or the hospice chaplains from Baptist Hospice who prayed with my sister at her bedside while the rest of us stood outside because she was dying from COVID.
Speaker 204
1:16:41
I remember those specific moments because of the people in this room. That is what hospice is. It is the care, love and attention that they show to people at a critical time. Those people make an impact.
Speaker 206
1:16:54
They made an impact on my life and they will forever be remembered. While there are also my competitors. They are organizations providing care
Speaker 200
1:17:03
in the same space that is delivered with quality and was provided in a compassionate way. I take the responsibility of being a hospice provider in the
state, seriously. You never get another opportunity to do it again. Capitalism, competition, none of us are speaking out against that today. Capitalism without quality care is what we are speaking against. The current process that is in place protects that. I ask that you both know on SB 269, as your constituents deserve quality hospice care. Thank you.
Speaker 210
1:17:35
Members, are there any questions of the witness?
Senator Clint Penzo
Unverified
1:17:43
Senator Penzo, you'll recognize her. Do, do you currently feel that uh all
the providers in the state are good providers. I believe all hospice
Speaker 217
1:17:55
is good hospice. If a family makes a decision to choose
Speaker 204
1:17:58
hospice for their loved one, they're making the hardest decision that they've ever had to make, and it is not my job to sit here and criticize any care that's provided, OK. Would you, would you
Senator Clint Penzo
Unverified
1:18:07
agree that there's portions of the state that aren't currently covered. I believe there's a good process in place.
Speaker 204
1:18:15
I believe that any more need, there's a good process to identify that. How, how big is your coverage area? You, you said pretty much the entire state. There are pockets where we don't cover and like I said, I could sit here and argue too that SB 269 would benefit us, but From an organizational standpoint, I will tell you we believe that this bill only will lead to more issues. We operate in other states where the certificate of need is not in place and it
Leads to all kinds of problems when it comes to quality of care, um, and it
Speaker 220
1:18:50
erodes. The ultimate experience for the patient and the family. Yeah, so, so if
Senator Clint Penzo
Unverified
1:18:56
this bill did pass, you would get competition from other providers in your, if they got to expand into your coverage areas probably. Hey buddy. Possibly possibly, OK. Thank you. Members, are there any other questions for the witness?
See, ma'am. Thank you for your testify.
I'm sorry, Senator Hill, sir, you're recognized. Could you just
Senator Ricky Hill
Unverified
1:19:25
kind of loot a little bit because you said that the company you're with is actually in some of these states currently doing what Senator Pinzo you kind of allude to some of the issues that they have a little bit more on that side of it and also expand into the Medicare fraud that you mentioned as well to
Speaker 217
1:19:42
take place. Sure, so I can speak specifically about Louisiana. Louisiana has a moratorium currently on any new hospice
licenses, um, they, um, have a high fraud, um, right, as does Texas. Um, you will see that hospice agencies
Speaker 204
1:20:00
open up. Um, they may have uh one thing you will encounter is they may open up, they may bring patients on service. Uh, their standard of care is usually pretty uh poor in that, like I said, they may see the patient once every 14 days. The nurse may show up, do the admission, provide morphine, Ativan, never see the family again, um, and they may
bill for daily services because it is a daily rate under Medicare, um, and as they are only being surveyed once every 3 years, um, they may close. Sharp, um, and in specifically in Louisiana and in Texas, what you run up against is the nursing homes typically are the ones that end up footing the bill because hospice agencies will go into the nursing home. They will work with the nursing home to take on a hospice patient and then they close up shop and don't pay their bill.
Senator Clint Penzo
Unverified
1:20:56
Members, are there any other questions? I have one, start to flip. So, so you, one
of the arguments earlier was, you know, if there's a 100 mile radius. They wouldn't be able to cover the 100 mile radius, it'd be 2 hour waits and you cover the whole state. Does that mean your patients have a 4 hour wait or a 3-hour wait. I
Speaker 204
1:21:18
would say to you that we can cover a large portion of the state because we strategically staff. I think most of the hospice agencies
here try and do the exact same thing. I think when you run into issues is that, and this is in Texas, this is in Louisiana. If you go into market where there are 15 hospice agencies within a small community, if you try and set a particular standard of care for how you want to run your agency and a particular nurse doesn't like that standard of care that you are trying to set, they can go and work for another agency, then it becomes a staffing nightmare, um, and it's all
about how well you can keep your staff. It's
Senator Clint Penzo
Unverified
1:21:59
a staffing nightmare for the company that I mean
for one company, it's a stabbing nightmare for the other one to to become more successful. Not
Speaker 204
1:22:08
necessarily, no, I would not agree with that argument at all. I think that in states where there are Lots of hospices, it is just it, it, if you're in healthcare right now, and this is obviously a healthcare committee, you understand staffing is an issue. We heard from Rachel earlier, which I was in support of that, of that bill about medication
assistance, um, you know, staffing is an issue in healthcare right now and
Senator Clint Penzo
Unverified
1:22:33
staffing was an issue with my sister 4 years ago, um, in, in Northwest Arkansas, one of the most densely populated places in the state. And and with with similar legislation for in-home care, uh, we were able to get a company that could actually cover from that had employees and her parents is not regulated like hospice is though. It's
Speaker 204
1:22:59
very different. The delivery model is very, very different in, in home care, non-medical care is not regulated to the
Senator Clint Penzo
Unverified
1:23:06
degree regulated differently, but the reality is they had employees locally when the local company did not. Have local employees and I would argue
Speaker 204
1:23:15
with you that hospice providers go into hospice because
Speaker 213
1:23:18
they have a hospice heart. You will find you. I will argue with
Speaker 175
1:23:24
one ordered, Mr. Chair, that hospice providers you're almost badgering the witness here. I'm
Speaker 233
1:23:31
sorry. I can take it with the point. I can take it. It's OK. Go ahead, sir. I'm I'm, I'm
good. Thank you. Thank you, sir. Thank you, Senator Penzo. Members, are there any other questions? Ma'am, thank you for your testimony today and you are dismissed. Thank you. The audience, is there anybody here to speak for the bill? See none, we have 3 left to speak against the bill. I'm
going to ask those witnesses, uh, to restrict your commerce to 2 minutes and cover anything that the other witnesses might not have covered before. We still have 51 bills left to do in this committee. And with that, Mr. Ryan Langston. Your Senator, I have nothing
to add. Thank you, sir. Mr. Greg Wood.
Speaker 236
1:24:36
So I know I'll keep it down to 2 minutes.
Speaker 239
1:24:45
Sure, if you will, please identify yourself. Sure, Greg Wood, and I am the president for the hospice and palliative Care Association of Arkansas, as well as um a Senator Flippo has mentioned, I'm the executive director of the hospice of the Ozarks in Mountain Home. To summarize what you've heard so far. I would like to just
share this. I'm a rule follower. And if this bill is passed, we will have 2 rules in our state that impact hospice care. And they're in direct conflict with each other. And because of that, It will become an issue for owners, providers. Our authority in our life. And this is what I mean by that. I showed up at the health services permit Agency commission meeting yesterday.
And I watched the process of 8 commissioners and the staff. Tried to make sense of the primitive approval regulations. As well as Act 817, that was Passed into law a few years ago. Where it extended home health, home care for 100 miles, which that's not the rule in the POA. I think our map from the association shows that there's
plenty of hospices. There's not a shortage of that situation to impact Arkansans, but I was in awe of the staff trying to balance The appeal process. of home care providers. That wanted to go 100 miles. But the conflict that that brings with the two regulations and I know that there's a couple of staff back here behind me, so I hope you're taking this as a
compliment because it truly is. I think it's one of the most difficult things to deal with when there are two laws that do not Work together. In healthcare. And so I would ask that we would You would consider voting no for SB 269. Thank you, sir.
Speaker 240
1:27:02
Members, are there any questions of the
witness? See then, sir, thank you for your testimony. You were dismissed.
OK. Mr. Charles Martin, sir, you recognized. If you will
Speaker 242
1:27:32
identify yourself. Thank you, Mr. Chairman. My name is Charles Martin. I'm the executive director of the Home Care Association of Arkansas. We are the association of Home Health Agencies that have some that has also has some hospice members, also has some personal care members. Predominantly we are skilled care home care. We
are the association that was most impacted by Act 817 of four years ago, and that's really where my um Speaking comes to here. It It took about 10 months for the about 9 months for the Arkansas Department of Health to develop regulations on that, uh, on that. We were not in favor of that bill as an association. We had some members who were. The um And, but they took very, they took great care just like our
the help, they're the ones that survey our agencies, our home health and hospice agencies. They took great care in developing the regulations and um I'm holding the regulations right here. It, they came out in on in February of 2022 after the bill was passed in 21. The, uh And the other part of Act 817 that I want to make sure we get clear is that there hasn't been a proliferation of home health agencies that have moved beyond their original 50 mile radius.
There have been some, but not many. They're like, there's a, the home, uh, the home health. piece that goes along with our industry, personal care, home health, and hospice. Keep the people in the home. There's a high Passionate high passion care for for taking care of your patient. It's not so much about the distance as it is about the patient. Yes, we have to make money, whether it's a nonprofit or a for-profit, and there are both, but uh it's all about, you
know, it's all about patient quality care. That was our concern about uh Act 817. Yes, Senator, it hasn't done the damage that Might have been, I don't know if the. Word was quite as extensive as what we said. Got it, Senator. As a fellow veteran, I'm not going to push that. So that I just wanted to. I just wanted to make that comment about that particular piece of it. Thanks for your service, brother.
Members, are there any questions? Of the witness.
See none, sir. Thank you for your testimony today. He Members that's our last witness, sent to Flippo, I'm sorry, Center Penzo, sir, you are recognized for your clothes.
Gene Eagle
Unverified
1:30:25
Thank you, Senator Penzo. I'll be very brief. I know if y'all already heard a lot of testimony, but I'd like to respond to some of the points that have been made. Uh, I've got 3 notes here, so to tell you on the front end, uh, I'll, I'll be brief and I mean it. Um, we have good providers in Arkansas. I think that's what all the testimony has been from those for and against this bill. They it's extremely important to note this bill does not allow for additional providers to come into Arkansas. The providers that are
In Arkansas are limited to those that are here currently, the, the agency could add more pursuant to its existing rules, uh, and, and bed need, but that, that's not changed whatsoever by this bill. All this bill would do is expand the geographic area within which the existing providers can provide services. There has been a lot of uh talk about how this larger geographic area would lead to significant
delays in coverage, uh, I would, I would implore you to consider that all these agencies are required as a condition of their license, which is a privilege to provide hospice services within the state of Arkansas to adequately staff their entire region. You heard from a witness who's uh company already covers the entire state. And I have no doubt that her testimony was accurate when she told you that her company is able to provide timely coverage throughout the state. So if her company can do it, other
companies can too. Um, and finally, with respect to the last witness's testimony regarding Act 817 of 2021, I think What you've seen with home health since that act is uh very uh uh instructive as to what you will see if this Act goes into effect, and that is that there aren't as many uh move as uh as, as a fear, the fears would uh would indicate. And by that I
mean, if you have an area that's already currently uh staffed, appropriately with a good provider, nobody's gonna want to move into there to Senator Flippo's point. It sounds like Mountain Home has a very good provider in place right now. Uh, I'd submit to you'd be crazy to try to move in there and compete with that provider who already has all those relationships in the town who already uh uh has a good reputation for providing good services. The places that will get new providers in are the places that are either
underserved or places where uh the, the local area is not happy with the service that they're getting. So for those reasons, uh, we would ask that you vote in favor of. bill to provide all the Arkansans with as much choice as they can get in making these, uh, extremely difficult decisions at the end of life for their loved ones. Thank you. Thank
Senator Clint Penzo
Unverified
1:33:22
you committee. I'll just real quick here, I just wanna kind of touch on My, my experiences with this, you know, and, and thank, thank
goodness I've actually got a uh uh facility like this in my
subdivision if my sister chooses to go there, I'm, I'm very fortunate if she decides to do it at the house. Hopefully they've got staff that can handle her at this point, but, you know, my situation 4 years
ago when, when I couldn't get in-home care for my sister. That, that opened up a lot of uh open minds to a lot of flaws. In the system. Um, you know, Northwest Arkansas shouldn't have been an issue.
How, how come a company It On the other side of the
state has staff. that they could have in my sister's home, but the company that's a uh an exit down the interstate from my house, couldn't. I mean, there, there are rural parts of this state where I was talking to a friend and he, uh, he told me 4. Friends of his couldn't get care. And if you look at the map that was handed out, It's, it's all lit up with
color. I mean, there's providers. Well, how come, how come this friend of mine couldn't get His friends couldn't get coverage and, and on the other side of the state in rural Arkansas. Um I, I just think, I think, you know, the, when there's protectionism and healthcare, um, the, the corporation's benefit. When, when, when regulations are relaxed, we're not talking about, there's not going to be more providers in this state. There's gonna be more coverage
in the state, uh, free markets allow people to move to, to where, you know, and this isn't a free market, we're not, we're not opening this up to more, more providers were, were opening up the area where people that aren't covered can get coverage. I mean, this, this is the end of life. This is, this is serious stuff. I mean, do we want people, um, you know, I, I hope, I hope that when my sister gets to this point that, um, you know, we've we've got um things, things are taken care of
in the Northwest Arkansas, we, we, my assumption is I'm in good shape. I'm one of the most populated parts of the state, but I'm in one of the most populated parts of the state when it came to in-home care, there, there were times where I was spending the night with her 4 nights a week because we didn't have coverage. I mean, that's, that's not acceptable. I mean, these, these companies aren't going to go out and take clients 2 hours away that they can't cover and, and, and if they do if they are trying to do that. The customer, if they've got somebody closer to him, it's,
it's a choice. We have to realize that people can make good choices. We don't need protectionism and healthcare. I'm not, and I'm not talking about opening it completely up. I'm, I'm relaxing, wanting to relax a little bit. It, it, it's been beneficial. Uh, it wasn't the end of the world four years ago. Gosh, it was the end of the world for in-home care. We're gonna, everybody's going out of business. And it's the same thing today. This is horrible. It's good for the patient. I mean, we can decide we're, you know, these people. We're we're either with the
patients or with protectionism. So I mean, I, I just would like to ask everybody for a good vote on this
bill. Members, are there any questions? Moving on, member, members are there. Any discussion. Is there any discussion? Sent to love. Thank you.
Senator Fredrick J. Love
Unverified
1:37:03
Thank you, Mr. Cherry. And Senator Penzo, I usually agree with you, but this is something I'm gonna, I'm, I'm
not gonna agree with you on because I don't think this is if somebody votes against your bill, it's protectionism. I mean, we could see we could see things totally different so for for you to characterize somebody's vote is protectionism. And not on the side of the patient, I think that's that's a that's a little bit much and so. I would just admonish you not to kind of characterize anybody's vote, just saying it's protectionism versus caring for the patient. That, that's, that's something
that I think is, is kind of. I think that's kind of over the line when you say that. I mean, we're just seeing two we're just seeing things differently, so, uh, I would say that. Thank you. Center
Hill, sir, you're recognized. love going on with uh
Senator Ricky Hill
Unverified
1:38:03
kind of what you said about protectionism and stuff. I, I didn't take it personally as Senator Penzo was talking about anyone here if we do vote as being protectionism. I'm, no, we disagreed earlier, but
I'm going to defend him here. I know his character and stuff. He's not trying to point at any of us in any way, uh, shape or form on that and I didn't agree with you on that, and, uh, side of it, but I don't think he meant any, anything derogatory toward that. So pencil, sir.
Speaker 246
1:38:32
Um My apologies, I get a little. passionate about this topic. But anyway,
You know, members and members of the audience, I think everybody here today, this is a really
tough subject. I think everybody here today, everybody here today is here. To make it better for our loved ones that are either in or going into hospice somewhere down the road we're going to all cross that river. And thank you all for being here. With that, Senator Penzo, uh,
Senator Clint Penzo
Unverified
1:39:18
are, are you closer? I'm closed and I'll make
a motion to pass and we have a
2nd, and with that, um, All in favor say aye. All in favor say no. Senator
Pencil, sir, your bill. Thank you. Members moving on, uh, to a different subject. Senator Payton, are you ready for a
Ready to present your bills Yeah. Boy, that was a. Everybody, everybody cares Yeah, yeah. John,
Speaker 252
1:40:10
let's wait just a couple of minutes for the room to clear. What do you make the
motion Mr. Chairman, I'd like to make a
Speaker 129
1:40:25
motion that we adjourn until next week.
Speaker 168
1:40:35
It won't bother me. Why I'm tempted Senator pain. Was that, was that, can we mean that or can we mean that to me? I guess I didn't realize what special
Senator John Payton
Unverified
1:40:50
order of business meant it equals special target on your back where you get the
business, OK, with that members, I'm getting ready to get started again. Senator Payton, sir, uh, if you will identify yourself.
Uh, John Payton San District 22 Wilburn, and so, you are recognized. Thank you
Senator John Payton
Unverified
1:41:12
and I know there's some members who stepped out. I'll be right back. But I want to thank the committee for still being here. Uh, I've got 5 bills that do 4 things, all related to workers' comp. And I'm sure all of us have heard quite a bit about them. Uh Um
I'm very familiar with workers' comp. I've, I've employed people since I was before I was 20 years old, uh, run several businesses. At the same time. Currently have 4 different businesses with Lots of employees. And uh I have fought on the House floor, on the side of business, uh in the workers' comp issue. And uh I didn't
Have any ghost of Christmas Past or or present or future visit me, but I did have a constituent. That had a workers' comp. Incident with her husband. They got hold of me about 3-4 years ago. And as I learned more and more about that case, I, I, I basically come to the realization that I think there's some Tweaks that need done to our system. Uh. Being the employer and
Becoming sympathetic to the employee. Through that process, I negotiated with myself quite a bit. I knew it was me because I recognized my voice. And uh What we have in front of us is the result of that. So it was 7 bills and now it's 5, and the dollar amounts
were higher, now they're lower because I negotiated with myself. I just wanna So that if it pleases
Speaker 261
1:43:05
the committee. I'll kind of talk about all 5
Senator John Payton
Unverified
1:43:13
bills at once here and then I'll bring up my constituent, Ms. Donna Scroggins to present her story so that she doesn't have to testify on every bill individually. We'll try to get some of the overview together here on the front end and then, and then we'll consider the bills. Yes, sir. Uh I've learned a lot about workers' comp. There's always been a tension between business and labor. And it has equaled.
Political differences. On different sides of the aisle, and I really, I really appreciate. What President Trump has done in recent years in reaching out and trying to represent and find a balance between both sides, the business and the labor, and I aspire to try to do that here today. There was a grand bargain many years ago. And it was an argument that the employees need to be protected.
And business wanted to be protected on the liability side. So the deal that was made was we will force business to carry Coverage for the workers that are injured. But will grant a lot of immunity to the business. on the liability side of the issue. And uh So that's what created this situation where me as a businessman, I'm forced by the state to purchase A product to protect my employees.
And me as an employee, I'm prevented by the state. From, from suing or, or holding the business liable. So that's, that's why we have workers' comp. Um I'm gonna bring Miss Scroggins to the table if you allow. Yes sir, and let her tell you her story. About her husband, he was a tradesman and He was successful and he was on the higher side of the wage
earners bracket and I was shocked to find out as an employer who who's paid many of these premiums for many years. I was shocked to find out that I was paying for coverage that didn't exist, and I think you'll See that I don't know if, I mean. I hate to have her drive all the way down here and spend all day. To sit here in front of an empty committee. And, and, I mean, I appreciate y'all being here and I know the others will be right back that
stepped out. Things pull us one way or the other. But, you know, We, we need to hear this story. And if you would introduce yourself, thank you. Yeah. Thank you, senators
Speaker 262
1:46:08
for having me here today, and I'm honored to help be a voice for injured workers, and thank
Donna Scroggins
Unverified
1:46:16
you, Senator. Oh, I'm good. Thank you, Senator John Payton for listening and introducing bills that could dramatically
change how injured workers are treated. My name is Donna Scroggins, and on October 26, 2018, not only my husband Tracy Scroggin's life was altered by a horrific work injury. It also impacted our family as a whole. My husband was a mechanic from the age of 19 to 49 and over his 30-year career, he became an expert in his field. My husband's accident was 100% preventable because of an
untrained, careless employee who did not follow directions and was possibly under the influence. My husband's career, his health, and his life will never be the same. He was crushed by a piece of heavy equipment by a co-worker. My husband was airlifted off the job, spent two weeks in the hospital over 6 months in a wheelchair. has had 11 major surgeries, countless months of physical therapy and more pain than one person should ever have to
endure. He also developed a debilitating nerve disease called CRPS, which is complex regional pain syndrome. Which is also referred in the medical profession as the suicide disease. According to the Miguel Payne index, it's one of the most painful diseases and more painful than an amputation performed without anesthesia. And out of the 11 surgeries, only 3 has been paid for by workers' compensation.
And I'm here to ask this committee to hear our story and to move forward with forward with these bills. So that other injured workers don't have to go through what we went through. These laws are outdated and have not kept up with the cost of living and higher paying jobs that have come into the state are not given equal financial benefits. The insurance carriers have no consequences when they are denying and delaying benefits to injured workers.
The injured workers have no choice to hire an attorney to get the benefits. Many good attorneys have their hands tied and work hard to get these benefits and the employees that the employees should already be getting. And then the attorney is not paid. That's why it's important to make sure that insurance carriers are responsible for the attorney fees when the attorney gets those benefits that the that the injured workers were already entitled to.
If insurance carriers had consequences, where the where the attorneys' fees come out of their pocket, it would perhaps force them to do the right thing and follow the laws. Unfortunately, insurance carriers have gotten away year after year with the same old loopholes and tactics for far too long. And if the laws is not changed, they will continue on the same path. Work injuries cause more than just physical health issues.
They also affect you mentally,
Speaker 270
1:49:32
emotionally, and put financial burdens on the injured workers and
Donna Scroggins
Unverified
1:49:38
their families. When injured workers have multiple injuries, it makes sense that they will need multiple specialists. The outdated to Doctor Rule does not accommodate all injured body parts. Injured carriers will often deny the physicians change or say specialists are unnecessary.
Our primary care physician played a key role in helping my husband get treatment through our, through our own personal insurance. When workers' compensation would not approve the treatment. Unfortunately, using doctors that are PCP send us to Met workers' compensation was not responsible for the bills that they should definitely be paying for. My husband spent over 6 months waiting to get treatment on his back. That was hurt.
Workers' compensation continued to deny him the treatment, even though it was clearly stated in the reports upon arriving at the hospital from the job site that his back was injured. By allowing a PCP to be part of the workers' compensation doctors, then your PCP would know if this was a new injury or if it was a pre-existing condition. For your PCP knows your health history. My husband has seen 4 orthopedic surgeons, a
neurologists, 2 new neurosurgeons, pain management. Home health care nurses, multiple physical therapists and his PCP. And he continues to this day to still see more and more providers. Coordinated care is a must. Not only to get better, but to get some quality of life back. The financial rule in 2018 was 66% of your wage and it was to
be paid to the injured worker until they're able to return to work. But there is a maximum cap of only 34,944 a year. My husband worked hard and dedicated. To his 30-year career and and was reflected in a high-paying job. The workers' compensation laws are not equal to the cost of living in the enormous inflation. I can tell you that because of the low cap on workers'
compensation that my husband was not paid 66% of his wage. He wasn't even paid 50% of his wage, not even 40%, but only 34%. That's 32% less than the 66%. With high inflation, the cap needs to be increased. When hardworking people choose to be educated and work hard on advancing in their careers. It doesn't and shouldn't mean that they should be paid less for
earning a higher wage, raising the cap to accommodate those that earn more would lessen the financial hardship on the injured workers and their families. Financial strain was a devastation to our family. It only took months for our savings to be gone. Our checking checking account drained. And we were soon facing foreclosure on our home. We could quickly became behind on bills. Future injured workers
desperately need these new bills to ensure fairness and keep up with the ever-changing economy. You may think my husband's case was an isolated case or that other injured workers don't face these issues, but unfortunately, over the course of the last past 6 years, I've talked with hundreds of injured workers who have faced the same issues, the same problems and share similar heartbreaking stories. The Arkansas Workers' Compensation laws may look good on paper, but
unless you have to actually use the Arkansas Workers' Compensation System. And deal with the workers' compensation carriers, then you can't possibly know the nightmare. The system is broken and we need new updated laws. One of the biggest complaints I hear from injured workers was also our biggest complaint. Why are the insurance companies allowed to treat us injured workers this way. When no change occurs, you
continue to continue to get the same outcome. Shortly after my husband's claim was mishandled and he was not treated right by workers' compensation, I started reaching out to representatives, and that's when I met Representative John Payton and now Senator Payton, who has listened and cared enough to put forth the effort to make the changes. I humbly ask you to join Senator Payton and to be a much-needed voice for Arkansas injured workers. Consider what it can
mean by passing these bills. No family wants to be at the mercy of the workers' compensation insurance carriers, helpless, alone, and nowhere to turn. These bills are vital to improving Arkansas workers' compensation system for a more fair treatment of injured workers. Our hard-working workforce deserves laws that would put injured workers, physical, mental, and financial health
first. My husband work injury had devastating effects to his physical health, but the emotional and mental toll and the financial burdens that was caused by workers' compensation doesn't happen, doesn't have to happen if we take what we know is wrong and change laws to improve the health of injured workers and have a better outcome. Thank you. Thank you, ma'am. Members, are
there any questions for the witness? I guess I
Senator John Payton
Unverified
1:55:41
I'd like to bring one up. With these bills in any way affect you and your husband's case,
Donna Scroggins
Unverified
1:55:52
or is it closed and finished. These bills will not help my husband because you are stuck in the year that Um, your accident happened. Although I do have children and I do have grandchildren and I have friends. I mean, everybody knows somebody. Our workforce needs to have better laws, so you're not faced up at becoming homeless if you're injured on
the job. Thank you. Ma'am, thank you for your testimony. And Senator Payton. So am
Senator John Payton
Unverified
1:56:23
I still in the present stage here? OK. So Colleagues She came to me while her case was open. Her husband's case was open. I did everything I could as a state representative to bring Workers' comp commission, workers' comp attorneys. Or any, anybody.
They, there's so many rules that they can't talk to you. You, you can't. Discuss a case with the workers' comp attorney. I mean, I, I ended up going to lobbyists to try to find out what could be done. And I, and I started to figure out how the, the deck is stacked. So drastically against getting any representation. As an injured worker.
Your attorney is is incentivized through the paper pay structure to reach a settlement, reach a settlement, reach a settlement. Not, not to get you the medical treatment that you need. And um We have, we have other people here that are prepared to testify for the bill. You can be excused, and I'm gonna bring Jason Hatfield up to help me answer questions as you have them. But now as we move to the list of bills, I've got a request. Senate Bill
284, 0, and we have a handout. I think most of y'all have already gotten it
over the last few days, but in case you don't have it with you. I have a handout I gave it to staff. One minute. It's the one that has the list of bills, starts at the
top with SB 284 through 288. Worker compensation we're passing out now. So I was gonna say is there's 5 bills, 2 of them do very, very
similar thing in, in two different sections of code and, and I'd like to kind of talk about those two first so we can talk about them together to vote on them separately, obviously, but that's SB 284 and SB 288. Senator Payne, go ahead,
and Senator Payton, I'm going to take us until 15 it's 12 o'clock now and then I'll, I'll. Uh go into recess until this this
Senator John Payton
Unverified
1:58:50
afternoon's meeting. OK, so SB 284 and 288 deal with the fact that we current limit currently
limit an injured workers. Uh, choice of physician. I have no choice basically now, uh, these physicians are in network and there's there's scales as to how they're paid, and Jason will be able to answer most of the details I'm going to cover from the top side, but They're only allowed one physician change in the life of
their case. And as you just heard a case can be several years' worth of needing medical. Treatment and several different specialties from, from the injury that may involve multiple body parts or whatever. So when we talk about limiting them to one position change, and then they get a physician that makes a mistake or like in her husband's case, there was a hip replacement or a knee replacement where they're gonna
have to have it redone and, and they don't trust that that first surgeon did it right, and they can't, and they're stuck, they can't change. Without going to the commission and, and uh a long process of requesting a waiver, basically to get a second physician when you have an attorney. That does it Hardly get paid anything to try to represent you in those cases. So the 1st 2, 284, 288, deal with the ability to change
positions no more than once a year. So instead of saying one time in the life of the case, it's gonna say no more than one time per year and uh I'll go ahead and let you talk about that shortly. Are we
Speaker 281
2:00:34
talking about both the 284 and 2888. So 288 a question right
Speaker 282
2:00:38
there. OK, whenever you say change positions once a year. uh Is that, does
Senator Ricky Hill
Unverified
2:00:43
that include specialists that you might be using, so that's why one doctor, are you allowed to have your doctor plus some different specialist. So that's why
Senator John Payton
Unverified
2:00:54
there's two different bills. One of them deals with the primary care physician. The other one deals with the specialists and so what we're saying is No more than once a year. We're not saying you can change once a year. We're not encouraging people to understand that, yeah, and we can amend that to 18 months, but the point of the of the matter is The current law. Say you get one change period and anything beyond that, you have to go justify before the board commission. Thank you. OK, thank you.
Speaker 149
2:01:26
Go ahead, Senator Love, do you have a
Senator Fredrick J. Love
Unverified
2:01:30
question? And maybe, and maybe the attorney can talk to this because I'm, I'm just trying to think why would they put that that piece in place was a Was it take uh cost containment piece or was
Senator John Payton
Unverified
2:01:43
it? I've always felt like it was to stop doctor shopping, which, which Where maybe an injured worker or somebody who, who was trying to embellish their injury and say it was more than it was, would go to multiple doctors to find who had the most favorable position.
Most favorable answer. It's odd because our current law is structured in a way where the insurance carrier can actually do that. The insurance carrier can Discover who's their most Sympathetic doctor to the insurance carrier and then direct all of their cases. To that doctor for review. And so we allow the insurance companies to doctor shop. But we're not allowing the worker to even change positions for good reason.
Jason Hatfield
Unverified
2:02:31
OK. All right. My name is Jason Hatfield. Uh, I live in Fayetteville and I have a law
Speaker 288
2:02:36
practice in Springdale, and I have spent 28 years representing injured workers in Arkansas. Um, right now, the insurance carrier determines where you go when you're injured, they determine where you go. You may have a primary care physician that you've had for 10 or 20 years, you're not allowed to go to that doctor. And that doctor is scared to see you because that would be unauthorized treatment. They
can't charge your health insurance because it's a worker's comp case, so you start the case going to whatever doctors the insurance carrier chooses. In regard to Ms. Scroggin's husband, it's not unusual for a worker to have multiple injuries. You might have a brain injury, uh, an eye injury and a knee injury. Under current Arkansas law, You can only change one doctor.
You have to choose which specialist you want to change, and you're stuck with all the other doctors, the insurance carrier chose. Additionally, Sometimes the insurance carrier chooses. I'm in northwest Arkansas. I represent Northwest Arkansas workers. They might choose a a specialist in Little Rock. A specialist in Tulsa, and so you're just trying to change a position. It's not doctor shopping. It's like my wife has
to work. She can't take me, take off, and take me to Little Rock and take me to Tulsa and take me to these doctors. I need my doctor in Northwest Arkansas. And so right now, You, you only get that one change of position, and you have to choose which specialist you want it to be. This bill, these two bills do two things. One, it allows you to change for each body part so
you could change your position for your brain, for your eye, for your back, and it allows you, if you have an established primary care physician. You can see that primary care physician as part of your workers' compensation claim. Um, And that's there shouldn't be any, all of these doctors get paid the same under the Arkansas fee schedule. Nobody can charge
more. They have to accept the Arkansas fee schedule when they accept You As a patient under Arkansas workers' comp. So the, there can be no argument that that would increase premiums. And in and in regard to the doctor shopping. The insurance carriers have doctors and one in particular. That they'll write a $3000 check to. Give the medical records and that doctor will give an
opinion, and it's usually that the treating physician's recommendations aren't necessary. And that forces us into litigation, which I'm kind of going into another bill now, but yeah, we need to but that forces us into litigation. But these two bills allow the primary care physician, if it's an established one. And who, and who is Miss Groggin says, who knows better about your condition than somebody that's been treating you and doing your wellness checkup for the last 10 years. They know whether you have pre-existing
condition or not, and it allows you a change of position per specialist per year. Whereas right now you only have one change of position in the lifetime of the case. I'm just trying to figure out what we're doing
Senator John Payton
Unverified
2:06:24
on our schedule here, you know, I assume we're gonna, I want
us to get through this first bill, so continue on. OK. Well, I think we could
Senator John Payton
Unverified
2:06:33
wait until for closing if if we have people signed up to speak
against it, but um where I'm ready to answer any questions on it. The committee has. I think members,
do you have any questions of the witness? Senator Hill,
Speaker 9
2:06:51
do you have a question? OK. Seeing none. You're dismissed. OK, I'm, I'm gonna start with uh, deer.
Randy, I can barely read your writing, nobody. Uh, Mr. Zan Zu, you recognize her? Yeah.
Speaker 294
2:07:49
committee, thank you for the opportunity to speak on this bill I brought with me, Karen McKinney, who will introduce herself in just a minute. She's uh one of the bona fide experts in the state on workers' comp, and I know you'll Learn a lot from her testimony. Um, let me just Make some comments though as as the senator has done already on all 5 bills, generally speaking, workers' compensation is one of Arkansas's most competitive
business assets in terms of cost of operating a business. We have an effective Efficient Affordable workers' comp system as a result of legislation in the early 90s. It's ranked as one of the 5 best in the country in terms of cost, especially. It's a big element in the decision making of people planning to expand or locate businesses in the state, but one
key element I want to make a key point I want to make here is this does not just apply to business. This applies to every employer in the state. a blast of the state of Arkansas. This applies to the highway department. This applies to the state legislature. that anybody who is an employer is a part of the state is affected by this. Higher ed, highway department, everybody. City government, county government, all are required as
employers, the system operates on behalf of employers, not just businesses. That's the point. And To say the least, these 5 controversial bills in our view will not just tweak the workers' comp system, but it will drive costs through the roof. We will see dramatic cost increases for every employer in the state. This will make Arkansas far less competitive than it is today in competition for business growth,
employment growth, job growth, investment growth, it will undermine much of the progress made with the tax reductions that you and your colleagues over the last several sessions have put in place. It will undermine that progress in terms of operating as an employer or especially as a business, because at the end of the day, A business especially doesn't matter to that business which pocket you take the money from. If it comes out of the workers'
comp pocket or the tax pocket. It's the same result for the business. Again, it affects every employer of the state, anybody with 3 or more employees. It includes state employees, and by the way, for the state budget, the proposed budget, I think the appropriation on the item for workers' comp claims is $15.5 million for next year. That number will be multiples of that if these bills are successful in our past. So with that, I'd like
to ask Karen to just give you some um information. and explanation of the processes involved in the workers'
Speaker 293
2:10:58
comp system. Ma'am, if you will identify yourself. My name is Karen
Speaker 297
2:11:03
McKinney. I'm an attorney here in Little Rock. Uh, I've been practicing workers' compensation law as an attorney since 2017. Before that, I was 13 years as a management commissioner at the Workers' Compensation commissioner. Prior to that, I was 4 years as an administrative law judge with the Workers'
Compensation commissioner and prior to that, I was a practicing attorney. So, uh, I think I may beat Jason Hatfield in a number of years of experience, but, but we're neck and neck there. Uh I believe that the first two bills that we're talking about today are 284 and 288. 284 is the is amending section 119. 508, which is the medical Bill for workers' comp that
governs how medical treatment is provided. The bill states that the employer shall provide medical treatment. The employer's obligated to provide that medical treatment. When you move into section 5. You asked about the change of position, why it was a one-time change prior to, and I, I may have my years wrong on this, but I believe it was in '97. There was an agreed-upon bill between
management and labor to before this, a claimant had a claimant had a right to change positions, but they had to petition the commission to change position, they had to have a hearing that had to prove that it was reasonable and necessary, and it was compelling. to change positions that increased litigation in '97, the law was changed to allow the claimant. The one time change of position. To anybody they want, no hearing, no questions asked. You
want your change, you get your change. It was to benefit the claimants for that purpose. That law allows you to change to a doctor who agrees to the managed care fee schedule. It also says, and it addresses your situation. It is already in the law as we see it here today. The claim it can change to their regular treating physician. Right now, if they want to.
Right now the law says the the claimant has the right to change positions. I'm skipping or to their regular treating physician of an employee who maintains the employee's records and with whom the employee has a bona fide doctor-patient relationship. I'm reading, not from the bill, but from the statute. The workers called the statute. They, they can do that. Now, the situation as Mrs. Scroggins explained her
treating physician referred Mr. Scroggins out. Had she chosen? to change to her primary care physician. Any doctor within that chain from your primary composition, a referral from your training doctor is covered under the act. Unfortunately, I don't know if it was legal advice received or how Ms. Scroggins's situation
came to be. Although, excuse me, I'm very familiar with her case. I'm the attorney that helped representing the respondents in that case. She was litigated. I can talk about the facts here, facts that aren't in here I won't talk about. But How, why she changed from doctor, they went from from Shreveport, go back home, we set them up with Doctor Henry Wallace, close to home to orthopedic physician close to home to treat, to treat.
They went outside. The doctor chosen by the workers' comp carrier and went to a doctor, Lawrence. They don't tell the workers' comp carrier. I don't know how they got to Doctor Lawrence. Doctor Lawrence says you need to see Doctor Joel Smith for your knee, refers to Doctor Joel Smith. At this point, they get a change of position. Center love, sir, you
Speaker 301
2:15:24
recognize? Well, I just, I know we're,
Speaker 302
2:15:30
we're discussing specifics. I just want to make sure that soed
Senator Fredrick J. Love
Unverified
2:15:35
opinion. OK, so that's all that's all I wanted to make
Speaker 296
2:15:38
sure that we were careful. I'm not going in telling you anything that is not in the written opinion, and if you would like to see the stipulated facts, I'll, I'll be glad
Speaker 297
2:15:49
to. So Dr. Joel Smith is the doctor with whom they were not pleased. And they go back to Dr. Lawrence. Yes, she got a one-time change to Doctor Smith and she was not
happy with Doctor Smith. It's not written in the statutes, but the workers' compensation laws have been Interpreted to when there is no longer a physician treating you under that change of position. Doctor Chalis was the physician of choice back in the 90s for climates attorneys. He probably had 50% of all the change of positions, he passed away.
The commission allowed a new change to be entered because there was no longer a doctor. Uh, doctors have moved out of state. There's a Doctor Ackerman that was treating a lot of patients. He moved out of state. The commission allows for you to get Another doctor when the patient Doctor relationship breaks down. There's no longer that relationship you can take it to the and Mr. Mr. uh Hatfield recognized you can take that to
the commission and ask for a change. You're not tied to one doctor or two doctors. You get any doctor you change to can always refer you out to another doctor. So the bill. is more restrictive and at the same time more liberal when allowing the change of position once a year.
I, uh, there will be attorneys recommending to their clients that they change positions once a year. That is going to increase medical expenses because they're going to go to another doctor, that doctor's going to charge you for reviewing all the medical records, they're gonna do this annually to keep their case open. They do this to get an impairment rating. They do this to prolong treatment. The other part, which was not mentioned is 284 also now places
restrictions on the carrier on getting an independent medical evaluation. In Miss Scroggins and her husband's case. Doctor Smith recommended Treatment We wanted a a surgery. I believe it was Doctor Smith. Doctor Smith recommended the, the surgery. We wanted a second opinion to verify whether or not this was reasonable and necessary. We sent him to the premier physician in the state
of Arkansas, Doctor Lowry Barnes at UAMS. He said yes. We said, Dr. Smith, you're authorized to do the surgery. IMAs are not meant. To cut off treatment. Some carriers may do that, but by and large, that's not what happens. Adjusters need to verify for their records. If, if you're going to spend $50,000 is the
$50,000 on this search reasonable necessary ma'am, I'm going to stop
you just for a second and Senator Hill, you'll recognize her. Yes, let's talk about
Senator Ricky Hill
Unverified
2:19:18
the bill. We're talking about a case now. Let's stay with, with the I think we've gotten that that we don't need to know
Speaker 296
2:19:25
about. I know, and I'm, no, I am talking about the
Senator Ricky Hill
Unverified
2:19:28
bill now on the on the on
Speaker 297
2:19:31
the independent medical evaluation. Um, it wasn't mentioned up here when they were talking about that, that's on the 2nd or last, on the last page of Senate Bill 284 is now,
whereas a claimant can get a change of position right now, no questions asked. Respondents now, if they want to get an independent medical evaluation on whether medical treatment is necessary, they have to petition the commission and it doesn't say they get their, their IME. It says they have to petition and therefore there's going to be more litigation on any time respondents want to verify and justify whether treatment is necessary.
Speaker 236
2:20:17
Members are there, OK, Senator Hill, you recognize
her. Members, I have a motion and a 2nd, all in favor, say aye, aye, and he opposed? With that, Senator Payton, would you like to close? I got a motion to pass. Kind of motion to pass in the second. All in favor say aye aye.
Well, Senator Payton, congratulations. Bill 284 has been passed. Thank you,
Senator John Payton
Unverified
2:20:54
Mr. Chair. Is it possible, since 288 is so similar that we go ahead and vote it with immediate consideration? OK, thank you.
Members and audience, I appreciate you being here today. We're going to Go into recess and then continue this after session today. Shower
Agenda
CALL TO ORDER
HB1245 Clowney TO CREATE THE ARKANSAS BEHAVIOR ANALYST REGISTRATION ACT.
REGULAR AGENDA
SB189 A. Clark TO AUTHORIZE IVERMECTIN FOR HUMAN USE TO BE SOLD WITHOUT A PRESCRIPTION OR CONSULTATION WITH A HEALTHCARE PROFESSIONAL.
HB1182 Bentley TO REPLACE THE DEFINED TERM "MEDICATION ASSISTIVE PERSON" WITH THE DEFINED TERM "CERTIFIED MEDICATION ASSISTANT" THROUGHOUT § 17-87-701 ET SEQ.
SB269 C. Penzo TO AMEND THE REQUIREMENTS REGARDING LOCATIONS FOR AND GEOGRAPHIC AREAS OF A HOSPICE AGENCY.
SPECIAL ORDER OF BUSINESS
SB284 J. Payton TO MODIFY THE EMPLOYER'S LIABILITY UNDER THE WORKERS' COMPENSATION LAW THAT RESULTED FROM INITIATED MEASURE 1948, NO. 4.
SB285 J. Payton TO MODIFY THE COMPENSATION RESTRICTIONS UNDER THE WORKERS' COMPENSATION LAW THAT RESULTED FROM INITIATED ACT 4 OF 1948.
SB286 J. Payton TO ALLOW ADDITIONAL WAGE LOSS BENEFITS IN ADDITION TO SCHEDULED INJURY PAYMENTS UNDER THE WORKERS' COMPENSATION LAW THAT RESULTED FROM INITIATED MEASURE 1948, NO. 4.
SB287 J. Payton TO MODIFY CERTAIN ATTORNEY FEES FOR CONTROVERTED MEDICAL EXPENSES, APPEALS, AND CHANGES OF PHYSICIANS UNDER THE WORKERS' COMPENSATION LAW THAT RESULTED FROM INITIATED MEASURE 1948, NO. 4.
SB288 J. Payton TO MODIFY A PHYSICIAN CHANGE UNDER THE WORKERS' COMPENSATION
LAW THAT RESULTED FROM INITIATED MEASURE 1948, NO. 4.
SB371 J. Scott TO ESTABLISH A STANDARDIZED SYSTEM TO AID IN THE SEARCH OF MISSING CHILDREN WHO DO NOT MEET THE CRITERIA FOR ACTIVATION OF THE ARKANSAS AMBER ALERT SYSTEM.
ADJOURNED
Documents
| Title | Type | Pages | Source |
|---|---|---|---|
| Agenda — PUBLIC HEALTH WELFARE AND LABOR COMMITTEE - SENATE AND HOUSE, Mar 5, 2025 | Agenda | 4 | Official source ↗ |
Speakers
Senator Missy Irvin Chair
Unverified
Senator Alan Clark
Unverified
Speaker 14
Senator Fredrick J. Love
Unverified
Senator Ricky Hill
Unverified
Speaker 33
Speaker 36
Senator Dave Wallace Chair
Unverified
Speaker 58
Speaker 74
Speaker 81
Senator Clint Penzo
Unverified
Speaker 89
Speaker 96
Gene Eagle
Unverified
Speaker 76
Katherine Grubbs
Unverified
Senator Scott Flippo
Unverified
Speaker 120
Speaker 123
Speaker 129
Speaker 153
Chair
Unverified
Speaker 163
Speaker 169
Speaker 167
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Speaker 184
Speaker 188
Speaker 182
Jason Hatfield
Unverified
Speaker 195
Speaker 197
Speaker 200
Speaker 203
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Speaker 217
Speaker 220
Speaker 213
Speaker 175
Speaker 233
Speaker 236
Speaker 239
Speaker 240
Speaker 242
Speaker 246
Speaker 252
Speaker 168
Senator John Payton
Unverified
Speaker 261
Speaker 262
Donna Scroggins
Unverified
Speaker 270
Speaker 281
Speaker 282
Speaker 149
Speaker 288
Speaker 9
Speaker 293
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Speaker 301
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Speaker 296