Public Health, Welfare and Labor Committee - Senate
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Transcript
1 document
Bills discussed (47)
| Bill | Title | Sponsor | Status |
|---|---|---|---|
|
SB117
· 5 mentions in agenda, chapter, transcript
Matched: “…k J. Love SPECIAL ORDER OF BUSINESS Number Sponsor Subtitle 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. |
|
HB1131
Act 959
· 2 mentions in chapter, agenda
Matched: “HB1131 Pilkington TO AUTHORIZE AN ADVANCED PRACTICE REGISTERED NUR…”
|
TO AUTHORIZE AN ADVANCED PRACTICE REGISTERED NURSE TO DELEGATE CERTAIN TASKS TO MEDICAL ASSISTANTS AND … | Pilkington | Notification that HB1131 is now Act 959 |
|
HB1166
Act 245
· 2 mentions in agenda, chapter
Matched: “…AIN TASKS TO MEDICAL ASSISTANTS AND OTHER UNLICENSED STAFF. HB1166 Gramlich TO CLARIFY THE TYPES OF EPINEPHRINE FOR USE IN ELE…”
|
TO CLARIFY THE TYPES OF EPINEPHRINE FOR USE IN ELEMENTARY AND SECONDARY SCHOOLS IN THIS … | Gramlich | Notification that HB1166 is now Act 245 |
|
HB1167
Act 431
· 2 mentions in chapter, agenda
Matched: “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 |
|
HB1213
Act 266
· 2 mentions in agenda, chapter
Matched: “…AMEND THE APPRENTICESHIP LICENSES IN SOLID WASTE LICENSING. HB1213 Achor TO AMEND THE ARKANSAS ATHLETIC TRAINERS ACT; TO CLARI…”
|
TO AMEND THE ARKANSAS ATHLETIC TRAINERS ACT; TO CLARIFY THE DEFINITION OF "ATHLETE"; AND TO … | Achor | Notification that HB1213 is now Act 266 |
|
HB1245
Act 432
· 2 mentions in chapter, agenda
Matched: “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 |
|
HB1254
Act 433
· 2 mentions in chapter, agenda
Matched: “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 |
|
HB1255
Act 857
· 2 mentions in agenda, chapter
Matched: “…ICE OF AUDIOLOGISTS. REGULAR AGENDA Number Sponsor Subtitle HB1255 Wooldridge TO AMEND THE COVERAGE OF A CONTINUOUS GLUCOSE MO…”
|
TO AMEND THE COVERAGE OF A CONTINUOUS GLUCOSE MONITOR IN THE ARKANSAS MEDICAID PROGRAM. | Wooldridge | Notification that HB1255 is now Act 857 |
|
HB1256
Act 231
· 2 mentions in chapter, agenda
Matched: “HB1256 Wooldridge TO REQUIRE THE ARKANSAS BOARD OF EXAMINERS IN CO…”
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TO REQUIRE THE ARKANSAS BOARD OF EXAMINERS IN COUNSELING TO ISSUE A PROVISIONAL LICENSE FOR … | Wooldridge | Notification that HB1256 is now Act 231 |
|
HB1257
Act 434
· 2 mentions in chapter, agenda
Matched: “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
· 2 mentions in chapter, agenda
Matched: “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 |
|
HB1447
Act 255
· 2 mentions in chapter, agenda
Matched: “HB1447 Long TO EXEMPT A SEPTIC SYSTEM INSTALLER LICENSED UNDER THE…”
|
TO EXEMPT A SEPTIC SYSTEM INSTALLER LICENSED UNDER THE ARKANSAS SEWAGE DISPOSAL SYSTEMS ACT FROM … | Long | Notification that HB1447 is now Act 255 |
|
HB1478
Act 230
· 2 mentions in chapter, agenda
Matched: “HB1478 Schulz TO REPEAL THE REGISTRATION OF DISEASE INTERVENTION S…”
|
TO REPEAL THE REGISTRATION OF DISEASE INTERVENTION SPECIALISTS. | Schulz | Notification that HB1478 is now Act 230 |
|
SB100
Act 482
· 2 mentions in chapter, agenda
Matched: “SB100 C. Penzo TO AUTHORIZE THE ARKANSAS MEDICAID PROGRAM TO RECO…”
|
TO AUTHORIZE THE ARKANSAS MEDICAID PROGRAM TO RECOGNIZE A PHYSICIAN ASSISTANT AS A PRIMARY CARE … | C. Penzo | Notification that SB100 is now Act 482 |
|
SB101
Act 300
· 2 mentions in chapter, agenda
Matched: “SB101 C. Penzo TO ESTABLISH THE PHYSICIAN ASSISTANT LICENSURE COM…”
|
TO ESTABLISH THE PHYSICIAN ASSISTANT LICENSURE COMPACT. | C. Penzo | Notification that SB101 is now Act 300 |
|
SB118
Act 517
· 2 mentions in agenda, chapter
Matched: “…SAS; AND TO CREATE THE ARKANSAS STATE BOARD OF NATUROPATHY. SB118 C. Penzo TO AMEND THE DEFINITION OF "AUDIOLOGY" RELATING TO…”
|
TO AMEND THE DEFINITION OF "AUDIOLOGY" RELATING TO THE PRACTICE OF AUDIOLOGISTS. | C. Penzo | Notification that SB118 is now Act 517 |
|
SB189
Act 396
· 2 mentions in agenda, chapter
Matched: “AGENDA (Revised 2/25/25 @ 2:30 PM) Moved SB189 to Regular Agenda Senate Committee on Public Health, Welfar…”
|
TO AUTHORIZE IVERMECTIN FOR HUMAN USE TO BE SOLD WITHOUT A PRESCRIPTION OR CONSULTATION WITH … | A. Clark | Notification that SB189 is now Act 396 |
|
SB222
Act 301
· 2 mentions in agenda, chapter
Matched: “…ONTINUOUS GLUCOSE MONITOR IN THE ARKANSAS MEDICAID PROGRAM. SB222 B. Davis TO AMEND THE MEDICAID PROVIDER-LED ORGANIZED CARE…”
|
TO AMEND THE MEDICAID PROVIDER-LED ORGANIZED CARE ACT; TO CLARIFY MARKETING BY PROVIDERS UNDER THE … | B. Davis | Notification that SB222 is now Act 301 |
|
SB264
Act 483
· 2 mentions in chapter, agenda
Matched: “SB264 Irvin TO ESTABLISH THE ARKANSAS PRIMARY CARE PAYMENT IMPROV…”
|
TO ESTABLISH THE ARKANSAS PRIMARY CARE PAYMENT IMPROVEMENT WORKING GROUP. | Irvin | Notification that SB264 is now Act 483 |
|
SB265
Act 294
· 2 mentions in agenda, chapter
Matched: “…HE ARKANSAS PRIMARY CARE PAYMENT IMPROVEMENT WORKING GROUP. SB265 Irvin TO REDUCE AND MODIFY THE MEMBERSHIP OF THE LICENSING…”
|
TO REDUCE AND MODIFY THE MEMBERSHIP OF THE LICENSING COMMITTEE RELATING TO WASTEWATER AND THE … | Irvin | Notification that SB265 is now Act 294 |
|
SB99
Act 437
· 2 mentions in chapter, agenda
Matched: “SB99 C. Penzo TO AUTHORIZE A PHYSICIAN ASSISTANT TO DELEGATE CER…”
|
TO AUTHORIZE A PHYSICIAN ASSISTANT TO DELEGATE CERTAIN TASKS. | C. Penzo | Notification that SB99 is now Act 437 |
|
HB1186
Act 960
· 1 mention in chapter
Matched: “HB1186 Vaught TO CREATE THE PAIN RELIEF PARITY ACT; AND TO REQUIRE…”
|
TO CREATE THE PAIN RELIEF PARITY ACT; AND TO REQUIRE PAIN RELIEF PARITY IN THE … | Vaught | Notification that HB1186 is now Act 960 |
|
HB1382
Act 481
· 1 mention in agenda
Matched: “…VIDE A CATEGORY FOR BENEFICIARIES WITH SICKLE CELL DISEASE. 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 |
|
SB111
Act 395
· 1 mention in chapter
Matched: “SB111 K. Hammer TO ESTABLISH THE DENTIST AND DENTAL HYGIENIST COM…”
|
TO ESTABLISH THE DENTIST AND DENTAL HYGIENIST COMPACT. | K. Hammer | Notification that SB111 is now Act 395 |
|
SB119
Act 269
· 1 mention in chapter
Matched: “SB119 C. Penzo TO ESTABLISH THE INTERSTATE MEDICAL LICENSURE COMP…”
|
TO ESTABLISH THE INTERSTATE MEDICAL LICENSURE COMPACT. | C. Penzo | Notification that SB119 is now Act 269 |
|
SB120
· 1 mention in agenda
Matched: “…SAS MEDICAID PROGRAM TO PERFORM ADDITIONAL CARE AND DUTIES. 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. |
|
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: “…F-STATE LICENSURE ACT TO PHYSICIAN ASSISTANTS. Page 2 of 3 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. |
|
SB17
Act 200
· 1 mention in transcript
Matched: “…de. choices for our Kansans and their healthcare needs. Um, Senate Bill 17, 117 does that. It, it, it allows the licensure”
|
TO CREATE LUX'S LAW; TO PROHIBIT THE SALE OF A DEAD HUMAN BODY THAT IS … | F. Love | Notification that SB17 is now Act 200 |
|
SB2
· 1 mention in agenda
Matched: “…L LICENSURE COMPACT. 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…”
|
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. |
|
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…”
|
TO CREATE THE VOLUNTARY PORTABLE BENEFIT ACCOUNT ACT. | J. Boyd | Sine Die adjournment |
|
SB255
· 1 mention in agenda
Matched: “…IFIED MEDICATION ASSISTANT" THROUGHOUT § 17-87- 701 ET SEQ. SB255 C. Penzo TO AMEND THE DEFINITION OF "DRUG" WITHIN THE FOOD,…”
|
TO AMEND THE DEFINITION OF "DRUG" WITHIN THE FOOD, DRUG, AND COSMETIC ACT; AND TO … | C. Penzo | Died in House Committee at Sine Die adjournment. |
|
SB262
· 1 mention in agenda
Matched: “…FOOD, DRUG, AND COSMETIC ACT; AND TO DECLARE AN EMERGENCY. SB262 C. Penzo TO AMEND THE CORPORATE PRACTICE OF MEDICINE DOCTRI…”
|
TO AMEND THE CORPORATE PRACTICE OF MEDICINE DOCTRINE; AND TO AUTHORIZE A LICENSED MEDICAL PROFESSIONAL … | C. Penzo | Died on House Calendar at Sine Die adjournment. |
|
SB269
· 1 mention in agenda
Matched: “…MAINTAIN OWNERSHIP UPON AN INACTIVE LICENSE OR RETIREMENT. 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. |
|
SB273
· 1 mention in agenda
Matched: “…ING LOCATIONS FOR AND GEOGRAPHIC AREAS OF A HOSPICE AGENCY. SB273 D. Wallace TO REQUIRE DIALYSIS CENTERS TO HAVE A BACKUP GEN…”
|
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: “…EQUIRE DIALYSIS CENTERS TO HAVE A BACKUP GENERATOR ON SITE. SB278 J. English TO REPEAL THE STATUTES CONCERNING THE OCCUPATION…”
|
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 |
|
SB284
· 1 mention in agenda
Matched: “…OMPENSATION LAW THAT RESULTED FROM INITIATED ACT 4 OF 1948. 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
· 1 mention in agenda
Matched: “…MANNER IN WHICH WAGE AND HOUR COMPLAINTS ARE INVESTIGATED. 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
· 1 mention in agenda
Matched: “…ATION LAW THAT RESULTED FROM INITIATED MEASURE 1948, NO. 4. 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
· 1 mention in agenda
Matched: “…ATION LAW THAT RESULTED FROM INITIATED MEASURE 1948, NO. 4. 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
· 1 mention in agenda
Matched: “…ATION LAW THAT RESULTED FROM INITIATED MEASURE 1948, NO. 4. 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 |
|
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…”
|
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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a bill that you want to speak on, you need to sign up at the sign up sheets over here if you want to speak for or against a bill, um, and just we welcome you all for being with us today. Um, today, we, you'll see we do have a large agenda. My intention is to go through our special orders of business and then to move to scope of practice bills, um, again, the committee members, if there's questions, you need to delay on something or whatever, just, let's just talk.
Through that, but um we'll go to the special orders of business and then uh go to the scope of practice bills. And here those before we go to the re the other bills that are listed on the regular agenda. Um, My intention today is that we are going to end uh this morning at 11:30. My members need to eat lunch and um and
then we'll come back upon adjournment and move through the rest of the regular agenda this afternoon. So, uh,
if you're here for any of those bills, you may want to come back this afternoon because we probably won't be able to get to any of those bills if they're not the
special orders of business or the scope of practice bills that are
listed on the agenda. Any questions? All right, seeing none, we will move forward. Senator Penzo. Senate Bill 117. And you have an amendment.
If you will pass out the amendment, uh, all the amendment does
is just add a house sponsor, is that correct? Senator, uh, if you'll just identify yourselves for
the record. Pennzo District 31. Mamie Burris. I live
Speaker 11
2:12
here in Little Rock. OK, thank you. Your amendment just simply
adds to how sponsor, is that correct? That is correct. OK, motion to adopt the
amendment, and second, all those in favor
say aye and opposed, I have an amendment is adopted, you may proceed with Senate
Senator Clint Penzo
Unverified
2:32
Bill 117 as amended. Thank you, committee. As you've noticed, I've
got several bills this session that have to do with uh healthcare, uh, my, my primary goal of this session was to increase access to healthcare, lower costs, and provide. choices for our Kansans and their healthcare needs. Um, Senate Bill 17, 117 does that. It, it, it allows the licensure
of naturopathic physicians in Arkansas. Uh, currently, they can practice in other states, but Arkansas doesn't acknowledge, um, uh, naturopathic physicians. And there are a lot of people in the state that say they are naturopathic physicians that only have like a couple week training course, and that's something we need to address too and actually people that have gone and got their doctorate. As a naturopathic physician in the states to allow them to
license and practice in Arkansas as they are allowed to do in other states. Um, To get started, I want to kind of give you my personal story on why this is so important to me. I You know, when I was in my late 20s, early 30s, I was running marathons, great shape, Jim, running and all of a sudden my hill started declining and I was having GI issues, um, went to multiple doctors. I had joint
pain, skin rashes, dandruff. There was all kinds of weird things happening with my body and I couldn't figure out what it was. I was putting on massive amounts of weight, lethargic, tired all the time. Um, fast forward a little bit of it. I gave up fast food and alcohol one year for Lent. And um so there was, you know, a period of time where I was eating clean just because I, you know, chose to take a lot of the things I desired out of my life, and started feeling better, but it was a gradual change and I didn't really notice it. Well,
of course, Lyn's over. I'm, I'm out having a couple of quarter pound, you know, triple quarter pound cheeseburger and you know, having some beverages and stuff and, and, uh Next day I wake up and I look 9 months pregnant, my stomach was bloated, distended. I could take little sips of water and, you know, it was just horrible, had horrible acid reflux up until that point too, but it was just everything was worse. So My doctor was giving me these cortisone creams for my face,
special shampoo, all these things going on, you know, taking pain medication for my joints and it was just a miserable time in my life. Went to 3 doctors, they kept, you know, tearing me up till I got to a GI specialist and he was like, oh, we can give you some drugs for the inflammation. We can scope you, and see what's going on in there, but nobody was really offering solutions. So I went home and I was talking to my family about what the next course of action should be, and I thought of this girl who went to college with.
And she said she was going to go to be a doctor. So I called her up and I was like, hey, June, I'm going to medical school, and she said, actually I went to naturopathic physician school in Arizona. And I was like, never heard of it. You know, what, what's the difference? And she starts telling me, and I said, well, I need your advice, and I told her the whole story. She said, Oh, Clint, you've got food allergies. She said, come in and we'll, we'll do some blood work. Well, of course, she can't draw blood. She was working under a chiropractor because she can't practice. She's a doctor.
In Arizona, but in Arkansas, she's the assistant to a chiropractor, OK, let that sink in. She diagnoses me over the phone. I come in, do blood work. We did the blood work comes back. She puts me on a, a six-month rotation diet explains the science behind why it's a rotation diet. I won't go into all the details. So all of a sudden, Over that six-month period, I dropped 70 pounds, joint pain went away. All the weird skin conditions went away. My
cholesterol went back down to normal, and keep in mind I'm eating beef fat, lard, duck fat. I'm not using any uh processed seed oils that have hexanes and other toxins in them, or food supply is trash in this country, um, and we need to address that as well, but You know, I was using switched to using olive oil, animal fats. Mom was all concerned, No, you're going to have a heart attack eating all these beef fats cause it's been trained into people for years that animal fats are poison, and you
need to use seed oils. Well, seeds are bird food. I mean, humans weren't meant to eat canola seed. Canola oil is probably one of the worst things you can put in your body. And so doctors don't tell you this, and I'm not here just to bash on allopathic. Medicine. There's a time and a place for it. But there's also a time and place for naturopathic medicine medicine, osteopathic medicine, chiropractor. Practic medicine. There's different doctors out there, and
I like to dictate my healthcare. I like to decide who I'm going to see. I've got a PCP that I go to and when I choose to go to the PCP, um, he does my blood work and all those types of things. Um, but I see my chiropractor and my physical therapist way more than I do my, uh, uh, allopathic doctor. So we need to understand that there's different types of medicine. Medical alternatives out there and we're hyperfocused on drugs
and surgery in this country, and we need to get back to exercise and diet. You can fix most of the ailments in this society with diet and exercise. Um, I know that my I have a family member that's uh diabetic and all of a sudden with a little bit of coaching from me, she went back to not being diabetic. They tried to put her on insulin. Well, years go by, health gets bad again, and she got a glucose monitor and that biofeedback from that glucose
monitor has kept her off insulin because she knows which foods, and most of them were recommended by our allopathic doctor to take to eat and, but with the feedback she can see which ones are causing blood sugar spikes and remove those from our diet and, and so she's been able to You know What I'm saying is drugs aren't always the answer. They can be a temporary crutch till we can figure out what the root cause is, but if you don't get to the root cause of why people are sick, you know, you,
you hear these commercials about drugs and they cause this, this, this, and this, and don't take it if you're allergic to the name of the drug. Well, how do you know you're allergic to the name of the drug? I mean, so The focus in our society is drugs. And I think the focus needs to be more directed to exercise, diet, and just a healthy lifestyle and naturopathic physicians. God, uh, a patient in that direction. So with that being said, I'll go ahead and turn it
over to Amy and let her kind of explain the training background. That's that they go through in a little bit about the history
Mamie Burris
Unverified
9:49
on naturopathic medicine. Good morning. Thank you, Chairman Irvin, Vice Chairman Wallace and Senators serving on this public health committee for allowing me the opportunity to speak in favor of SB 117 to license naturopathic doctors in Arkansas, and a special thank you to Senator Penzo for sponsoring this bill. My name is Mamie Burris and I
was born and raised in Little Rock. I'm a Vermont licensed naturopathic doctor and an Arkansas licensed acupuncturist. Like many Arkansans, I'm no stranger to chronic health issues. My gastrointestinal symptoms started when I was about 6 years old and I suffered on an almost daily basis for two decades. My conventional doctors meant well, and they did what they were trained to do, prescribe pharmaceut ut ical s But these over the
counter and prescription medications did not address the root causes of my symptoms, and so I continued to accumulate health issues as the years went on, including chronic fatigue, hormonal imbalances that affected me significantly on a monthly basis, eczema and other skin problems, and eventually thyroid autoimmunity. I remember asking my doctors on multiple occasions, if there was something more I could do was my diet causing my symptoms. Did I need to change something I was
doing. Each time I was told that the food I was eating was not causing my health issues and that I would probably always have symptoms. This couldn't have been further from the truth. I went to college at the UFA in Fayetteville and earned a pre-medical microbiology major with every intention of going to medical school because I knew I wanted a career that helped others, and I knew I wanted to be in healthcare. During my senior year, I had an epiphany
that I did not want to be the kind of doctor I had access to. I realized I wanted to learn how to use food as medicine, and I had an interest in natural therapies like herbs and vitamins. When I discovered naturopathic medicine, I was drawn to its principles of utilizing the healing power of nature, identifying and treating the root causes of symptoms, treating the whole person. That my role as a doctor should
be to teach and empower my patients, and prevention is the best medicine. I instantly knew this was the direction I wanted to go. So I moved to Portland, Oregon and began my training at National University of Natural Medicine, the oldest accredited naturopathic medical
Mamie Burris
Unverified
12:35
federally and regionally accredited 4-year medical program recognized by the US Department of Education consisted of over 4100 credit
hours that included basic sciences like anatomy, which also involved a cadaver lab, physiology, biochemistry, and histology and clinical sciences such as pathology, immunology, gastroenterology, cardiology, gynecology, dermatology, endocrinology. Oncology, neurology, pharmacology, emergency medicine, pediatrics, geriatrics, H E E N T, which is head, eyes, ears, nose, and
throat. Physical examinations, laboratory diagnosis, phlebotomy, diagnostic imaging, minor surgery, and intravenous or IV therapy. I had over 140 hours of clinical nutrition and over 580 hours of botanical medicine, hydro. ther ap y physical medicine, and other naturopathic modalities. During my 2nd, 3rd and 4th years I had over 1200 hours of supervised clinical rotations, working under the guidance of
not only naturopathic doctors, but also medical doctors, osteopathic doctors and chiropractors where I practiced counseling patients on diet and lifestyle, performing physical examinations, ordering and analyzing lab results and diagnosing conditions. prescribing and managing pharmaceuticals, formulating and administering IVs and other injection therapies, ordering and interpreting diagnostic imaging and EKGs, performing minor surgery, practicing
physical medicine techniques like naturopathic manipulation, which is similar to chiropractic adjustments, customizing herbal formulas and utilizing nutraceuticals. As I was able to implement what I was learning and through working with naturopathic doctors as a patient, I was able to completely change my health. After nearly 20 years of suffering unnecessarily, I finally knew what it was like to go days, then weeks, then months
without experiencing the chronic symptoms that had plagued me for so long. I also had the pleasure and honor of witnessing the power of naturopathic medicine with my patients at the student clinics and then in my own practice after graduating in 2012. After I earned my doctorate in naturopathic medicine and passed my board examinations, I practiced in California as a licensed naturopathic doctor. During that time, I reflected on my own health journey, how conventional medicine had failed
to help my chronic issues and how I had to move to Oregon and study naturopathic medicine in order to finally get the answers and relief I had so desperately wanted. I realized that there were others in Arkansas who were also suffering. suffering from chronic symptoms and who deserved the option of naturopathic medicine. So in 2014, I started traveling to Arkansas for 1 to 2 weeks every few months to offer my services. I quickly realized that many Arkansans were desperate for
this type of care. They wanted to know how they could use food therapeutically to heal their bodies, and what they could do in their day to day lives to take control of their health. They were tired of only being handed a prescription. which often caused unwanted side effects. They wanted to feel empowered to better understand their bodies, their health, what was causing their symptoms, how their symptoms were connected and what they could do to actually resolve their symptoms.
So in 2015, I moved back to Arkansas to offer my services full time, even though it meant I would have to sacrifice the ability to offer many of the skills and tools I'd spent so much time, energy, and money to learn. This is how badly I wanted to help Arkansans, and this is how incredibly powerful diet, lifestyle, and natural therapies like herbal medicine and nutraceuticals really are. Over the years, I've been blessed to empower hundreds of
people to regain control of their health. I've helped patients normalize their blood sugar regulation, optimize their cholesterol, lower their blood pressure, weight, heal anxiety and depression eradicate chronic fatigue and insomnia, balance their hormones to eliminate menstrual dysfunction and irregularities and symptoms of perimenopause and menopause, address gut symptoms like constipation and reflux, resolve in fertility and successfully
conceive, halt their chronic pain and so much more. Many of my patients have also been able to safely discontinue pharmaceuticals, they were told they would be on for the rest of their lives because they no longer needed them, and to drop diagnoses they were given because they no longer met the diagnostic criteria, including prediabetes and diabetes, which collectively affect roughly 46% of Arkansans. I've also worked with patients who have fallen through the
cracks and helped them to get answers so they could receive appropriate care, which has included referrals to physicians when medications are indicated, such as in the case of hypothyroidism that was only discovered because I ran more extensive testing than the standard of care. Arkansas spends billions of dollars on healthcare each year, and much of that is spent on chronic conditions that are preventable and reversible.
Arkansas is also facing a growing physician shortage. Licensing qualified naturopathic doctors will not only ensure that Arkansans have access to this incredibly effective form of care. It will also reduce spending on healthcare, help combat the physician shortage that we're facing and expand insurance coverage for natural approach natural approaches to health and healing. Licensing qualified natural op ath ic doctors will also protect Arkansas citizens by
preventing practitioners from using the terms naturopathic doctor or naturopathic medicine without the proper medical training and credentials. Naturopathic medicine has been such a gift in my life and in the lives of so many others. Please don't stand in the way of this gift. There is no shortage of chronically ill people in Arkansas and medically trained naturopathic doctors. bring a different perspective and approach that is very effective for chronic health
conditions. We want to work alongside conventional doctors and other healthcare professionals to ensure Arkansans have access to the best care possible. Please vote in favor of SB 117 to license qualified naturopathic doctors in Arkansas. We are, after all, the natural state. So shouldn't this powerful form of natural medicine also part of our healthcare system. Thank you so much for your time and attention. I'm happy to answer any questions you have.
Thank you. Are there questions from
members of the committee? OK. I have a couple of
questions just uh briefly, um, One is, um, You're creating a new board, uh, correct, Senator Pence in this, in this bill that
Senator Clint Penzo
Unverified
20:19
is correct um initially, uh before we amended it, I was going to put them, place them under the Uh
physician board but um, The medical board doesn't really want them. So I decided to
establish a new board. OK. Would there be enough people qualified, uh, to serve on this board in the
state of Arkansas. Do you know that there are enough, I mean, because you, you just in your opening comments you were talking about there are people that are identifying as such, but only have taken like a few week, few week course or something versus a different and
Senator Clint Penzo
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21:02
you can look at some communities might have 20 people that call themselves naturopathic providers of some sort, uh, and one of them might be qualified. So I do think there's enough in the state. Uh, a lot of them keep their head down because of scrutiny, um. There are multiple colleagues that I've spoken
Speaker 48
21:21
with who would love to come to Arkansas and practice, but they are not doing so because of the licensure status. OK, but
I, I, I understand. I'm, I'm just, you've got 13 members appointed by the governor for terms of 6 years. I mean, I don't know if there are 13 people currently residing in the state of Arkansas that has the I assume that these board members would have to have what you've outlined in the bill for quote licensure that
Senator Clint Penzo
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21:55
is, that is correct, OK, and I'm, I'm
happy to amend the number of committee members if need be, um, that's a
very minor issue. Well, I, I think I think I think it may be important to make sure that the board members have the level of education that you require in the bill for licensure in order
Senator Clint Penzo
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22:20
to serve on the board and to to be on
the board, but I think the language might need to That's one of my questions or concerns about making sure that that language, uh, would be, would be um that language would be part of the
board section of this, um, then I, I don't disagree with you that I think food is medicine and I think, I, I mean, so, and I, I know there are a lot of medical doctors that do practice like that in the state of Arkansas. So I just, I want to make sure that we're not, you know, casting a wide net there because I can tell you like my personal story as well, you know, my, my mother had a tremendous tragedy. With a ruptured appendix and the surgeon, you know, had to do 3 surgeries to remove that
appendix. It was just traumatic. The only way that she was able to heal from that though is from internal medicine and an infectious disease medical physician who really prescribed high nutrition and, and that's how she, her wound healed was because of the nutritional aspect and using food as medicine, I think is a good thing, and I don't disagree with you about that, um. One of the, uh, and so I just
wanna make sure, you know, when we're making that statement, so,
but I understand you don't have you're, you're not including prescriptive authority, uh, for drugs, I guess because that would be
antithetical to what you practice that in
Senator Clint Penzo
Unverified
23:50
other states, they do have prescriptive authority and they do have abilities to do minor surgeries, so they have been trained, uh, in that. It's just that it's very rare. Uh, it could be with hormones. replacement creams and things like that. So I mean, they, they, it is indicated in some instances, but they usually rely
on, uh, natural methods instead of prescriptions, but your bill
does not give prescriptive authority for scheduled class drugs removed it just to make it
Senator Clint Penzo
Unverified
24:21
more palatable. to the state until we get accustomed to what naturopathic physicians are, so, uh, that was, that was my decision to pull that out. I got you, but you have a full intentions
of increasing that scope of practice to full prescriptive authority in the future. It depends, depends what it looks
Senator Clint Penzo
Unverified
24:44
like, um, you know, depends on feedback from
the community. I mean, yeah, and then when you say on page 12, use routes of administration of medication that include you, those are the That medication that you're talking about would be non-prescriptive medication, is that
correct in that section of the bill, OK. And then, um, one of the things that I, I just wanted to ask a question about is I understand your abbreviation of ND, but to me, I
think NMD is confusing and I'm not sure if I, I'm not sure if I would, I think that would be confusing for the public, so I I have a problem with that little section on page 5, and I just, I'm just throwing that out there to you, but um, And then my last thing is, uh, you were talking about um being paid, you know, by insurance companies and things like that. Um, have you done a requested a fiscal impact statement on your bill from DHS Medicaid or
ABD because you, because this would be
ordering laboratory examinations, ordering dinos diagnostic imaging studies in order, order and based it on a radiologist's report, take action on diagnostic imaging studies in a manner consistent with the naturopathic training. I have not, because if you're either
Senator Clint Penzo
Unverified
26:08
gonna go to your doctor and do it or to your naturopathic doctrine to your Paco. So I mean, I really don't see a Uh, uh
physical impact if you're choosing a different healthcare provider to run your tests, then, so, I mean, I think it's 61, half a dozen of another. Sure, well, I just, I
know we, you know, we can members can have asked for fiscal impact statements on other bills that would maybe potentially affect Medicaid, so I think the reason why asked specifically about laboratory examinations and diagnostic imaging is because we did add another category of dying.
Gnostic imaging services and increase that category with chiropractors, and it, it was a tremendous, it was a tremendous fiscal impact and it caused some problem serious issues with primary care physicians not having enough allotment for those Medicaid patients to order the blood work that they needed. So I just think on that we need to kind of be considerate of, of that because there are caps and limits in Medicaid for Medicaid patients and sometimes We need to make sure we're just
Senator Clint Penzo
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27:23
acknowledging that, so that's that's, um, you know, this is, we've talked about this several times and it's been filed for well over a month and I've ran it several times in the past, I would have It could have been brought up before today, but I understand. um, you, you mentioned all, not all doctors can
be clumped together. That's, that's true. I mean, I've got a cousin, a cousin who's an allopathic surgeon. He does back surgery, um, I think there's a time and a place. Uh, speaking of back
surgery, um, there's a, a back surgeon in Northwest Arkansas that uh after doing surgeries for years, he decided to invest in a physical therapy clinic, get special equipment. every patient before he does surgery, he runs them through a physical therapy, uh, so yeah, he runs them through physical therapy and makes sure that physical therapy won't fix it, and then if it doesn't, then he does surgery. So, uh, medicine is evolving, and I think more doctors are understanding the importance of holistic medicine,
um, but I remember doing bone density screening back when I worked in healthcare, and there was a doctor and we were having lunch and it was me, him and a nurse and, and my PT supervisor. And I was big into nutrition back then and, and, uh He, the doctor, she was drinking a apple juice, and he said, you're better off chasing a multivitamin with a Coke. been drinking that apple juice. And I kind of leaned back in my chair and about that
time I got kicked in the shin by my supervisor. He just shook his
head at me. I mean, the, the worst thing you can do for bone density is to drink Cokes and we're the bone density screening, and he's telling the nurse that she's better off to drink a Coke with a multivitamin because then she'd get more vitamins. But drinking Cokes will deplete. Calcium from your bones. So I mean it's not all doctors, they have 0 to 12 hours of training and naturalopathic physicians have well over 100 hours of dietary training. So, I mean, some medical schools don't even
have I was talking to a representative in Texas, and he filed a bill and he said I should run it in Arkansas, and it establishes minimum required hours, um, of how much nutrition training doctors have to have because there I don't, I don't know that we have any in Arkansas. But uh when they get up here, they can, uh, tell us what their nutritional training is in medical school. Well, I I can speak to that.
My husband went through medical school. They have a lot of training through 4 years of medical
school and 3 years of residency on all issues and also with that, but, um, we, we would, uh, and he, he literally writes prescriptions on his prescription pad for, for, for patients to walk and follow dietary plans, so, again, I think it's important, it's important part of medicine for sure, um, and then, and then I just, you know, one of the things too, though, with the physical therapy, I, I, but insurance will require physical therapy before surgery, and a lot of
times before they will authorize the surgery. So, um, a lot of that is also kind of guided by what's happening with the payers as well. Um, OK, any other questions from members of the committee? All right. See none. 0000, I'm sorry, Senator Hill, you have a question. Senator Penzel, you
Senator Ricky Hill
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30:48
mentioned several times other states that offer this. What other states offer this? Mimi can probably answer that question better
Senator Clint Penzo
Unverified
30:55
than I can. So there's currently 26 other
Speaker 48
31:00
states in the US that license and regulate naturopathic doctors. California, Oregon, Washington, uh, Minnesota, um, Arizona, so
Speaker 70
31:07
roughly 50%. Correct. And you may be more
Senator Ricky Hill
Unverified
31:14
suited for our next question here. Uh, as far as the training goal to become a physician. What, what is your training consist of? Hours of study, hours of residency, etc. compared to an MD,
Speaker 48
31:32
as I mentioned, it was a 4-year medical program with over 4100 credit hours, 1200 hours were supervised clinical rotations were not required to complete a residency, but many healthcare professionals don't have to complete a residency. OK. Nurse practitioners, physician assistants. So, so how, how do you
Senator Ricky Hill
Unverified
31:55
get your actual training then? We have,
Speaker 48
31:58
we have student clinics, several student clinics that were working at under the
supervision of naturopathic doctors, medical doctors, osteopathic doctors, chiropractors. So we have clinical rotations that we're doing our 2nd, 3rd, and 4th year in school, over 1200 hours of that. Thank you for that. Are there other
questions from members of the committee?
Senator Clint Penzo
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32:21
I, I would like to. This just popped in my head, but we, we allow Pretty, pretty high
scope for physicians assistants and APRNs in this state. But yet
People licensed as doctors in other states. We won't even let them. practice in Arkansas. Um, So that's something I
think we need to consider as well. You're practicing
currently, is that correct? I'm practicing under my
Speaker 48
32:49
acupuncture license, yes. OK. I went and got additional training so that would actually be
Speaker 70
32:54
able to offer more services to, to patients here. All
right, thank you. Let me ask one more question. Do you identify yourself though currently as a naturopathic.
Speaker 48
33:06
I identify myself as a naturopathic doctor because I have a doctor in naturopathic medicine, yes, OK, but
you're working under the licensure of acupuncture. I'm very clear and um any communication with a
Speaker 48
33:15
patient before they work with me that naturopathic medicine isn't licensed in Arkansas. I'm not a medical doctor and I'm not to take the place of a medical doctor, and they need to have a medical doctor on their healthcare team if they're working with me. OK. Yes, Senator Hill.
Mamie Burris
Unverified
33:28
Senator Pinz, I want to go back to a comment you made earlier,
Senator Ricky Hill
Unverified
33:37
you made a comment about the drugs, all the cause and effects on there that's listed, whether it be irritable bowel syndrome or whatever. I'm kind of paraphrasing there. Do you realize that most of those Reasons that are listed there because of attorneys, not necessarily the symptoms themselves, but a lot of it's because attorneys we're using attorneys to tell. The pharmaceutical companies what to say. Oh no, it's I guess my question would be, do we want an attorney telling us that when we go, when we're sick, do we want an attorney telling us, you know, this could happen to you or we want a doctor telling us
Senator Clint Penzo
Unverified
34:07
this. I would say that if there's a disclosure. On a drug. It's because those symptoms presented during the trials. So those things did happen. Now maybe attorney got involved and made them disclose it, which informed consent is very important in, in medical care. So
Yes, those symptoms, you know, bleeding gums or may cause
seizures or, I mean, there's a laundry list of Things that happened during trials and the people scare if you look at it. Oh, it's very scary, you know, and it's, uh, you know, some of them you might be more likely to get struck by lightning, but I mean, the, the reality is it is a chance and you need to be informed. I mean, there was, there's been a lot of drugs put out there that have, have hurt a lot of people, um. And I'm not disagreeing with
Senator Ricky Hill
Unverified
35:03
that. I just want to make sure that it's known that that most of those causes there, yeah, they may have been a symptom,
but attorneys caused that to be there for lawsuits and everything
else. Yeah, I mean, because people deserve informed consent. Yeah, OK. My next, my
next question for you is, Uh, the prescription side of it you were mentioning a while ago that you know, natural stuff that you can prescribe yourself is all that is any of that FDA approved? I know some of it is, but are you prescribing these
uh whether it be a natural herb or some other the FDA approved. Well, I'm not the one
Senator Clint Penzo
Unverified
35:40
prescribing them, so I would, I would refer that to her. So you've seen the things that she's currently in
Speaker 48
35:46
this state today. The FDA, I don't believe approves, uh, the use of herbs, vitamins or minerals for any particular condition. OK, thank you. Thank
you. Are there any other questions from members of the committee? All right, seeing none. Thank you so much.
Um, we have, uh, someone to speak against, Scott Smith, Arkansas Medical Society. You're recognized. We'll come back up close. there if you want to
Speaker 94
36:16
Thank you, Madam Chair, members of the committee. I'm Scott Smith with Arkansas Medical Society, um, thank you for hearing us and I want to thank Senator Penzo, we've been talking about this bill now for a little while, and there have been some amendments, and we appreciate that. We still have some pretty serious concerns about the bill. The information I have as it pertains to the states that currently allow naturopath. Practice are 23 and there are 3 states Tennessee, South
Carolina, and Florida specifically prohibit the practice of naturopathy. So that would mean that there would be remaining 24 states of which we're one that don't, that are silent on the issue right now. That's the information that I've been given, but we still have um some concerns about the bill and in particular, Senator mentioned at the top of page 3, language is very vague as to the consistency of naturopathic you speak into the
mic? Sorry, we just need you to be a little more loud. Naturopathic education and training, so screening that's consistent with that, we don't understand exactly what that would be. Then you've got after that lines 4 and 5 system of healthcare for the prevention, diagnosis and treatment of the human health conditions. injury and disease again, concerns about that.
Speaker 97
37:48
Take a look at the back of page 11. The bottom of the
Speaker 94
37:54
page, the scope of practice includes uh diagnostic imaging studies. Got real concerns about that as well. What would be done with that? Um, and ordering labs, we've just got a lot of questions and concerns about that and we're not. Um Confident in the educational. Uh, curriculum. We understand that there are 6 schools around the country. Uh, there's one in, I guess,
Arizona, right? And 2 in California, 1 in Washington, Oregon, and I believe Illinois, um, but, um, we just have some real concerns about The
Speaker 98
38:30
extent to which that education carries into this, and so that's really all I have.
Senator John Payton
Unverified
38:41
question. Thank you. Thank you, Madam Chair. So Medical
society, right? So Does the medical society
acknowledge That there is success in this field and, or do they just
deny that there's any legitimate medical treatment coming from this field. I don't, I don't know
Speaker 94
39:04
that we've taken a position specifically as to any efficacy of any given treatment. I think to some degree if if we're sick, sometimes the body takes care of itself if you're sick in 10 days. So the reason I was asking is because I thought Senator
Senator John Payton
Unverified
39:21
Penzo. Made the statement that originally he had offered in this bill. To put the regulation of this branch of medicine under the medical board. And that he had to take it out of the bill because the medical board was adverse to that. So I'm just, if you have concerns about the level of training and concerns about what the bill says is going to be requirements to be licensed, why wouldn't you have wanted to be the board that oversaw that.
Speaker 94
39:54
Well, the medical society, we are not the medical board and I, I have not talked to the medical board about their particular if they talked
Senator John Payton
Unverified
40:05
to Senator Pino about as a society, doctors in general just Shun this method of treatment and think it's not worthy of Pursuing,
Speaker 98
40:13
I don't know if I could say that there are probably some physicians, MD physicians that may incorporate. I don't, I really don't know. OK, thank you. Thank you, Madam Chair.
Thank you, Senator, Senator Love, we are on Senate Bill 117. Yes, welcome. Uh, Senator Hill, you're recognized for a question? You made a comment on
Senator Ricky Hill
Unverified
40:35
3 different pages you had concerns. Tell me those concerns. Be a little more detailed than what you are. I mean, concerns expressed them. Well, there's a lot
Speaker 97
40:43
of vagueness. OK, tell us what that is. Well, The very
Speaker 94
40:50
first line on page 3, referring to a screening or a test that is consistent with
naturopathic education and training. I don't, I really don't know what that is. That's Um Then the other, well, right underneath that we've got a system of healthcare for the prevention, diagnosis and treatment of human health conditions. Injury and disease, that's really broad. That's incredibly broad language. So I guess that's what we're coming down to is that there's a lot of
Senator Ricky Hill
Unverified
41:27
of uncertainty in the bill as well. Does that not go back to kind of what Senator Payton just said though, if it was
Speaker 114
41:38
a concern that Why didn't y'all grab a hold of that? Well, we, we are, like I
Speaker 94
41:44
said, we're not the medical board. And we've had opportunity to talk to Senator Penzo on different occasions, and he knows that we remain concerned even though the prescribing part was taken out. We appreciate that. Thank you. Thank you.
I have a quick question just to follow up on that, but is it,
is it safe to say that naturopathy as a form of treatment is incorporated in many medical doctors uh in their
is if you're defining naturopathy as using foods and and for treatments and physical therapy
and everything that Senator Penzo testified, there are many physicians that utilize all of those aspects within their, their
Care, but I, I mean, but that's, that's a different, that's different, OK, you know, diet
Speaker 98
42:35
and healthy living or diet, healthy living an important part in most physicians would advocate for that.
Speaker 106
42:40
Well, actually they, there's preventive care models
and requirements that you, your wellness checks include a lot of those in at
least in primary care they do. I'm not sure if it does in orthopedics or cardiology or anything like
that. OK. Um, Senator, um, Penzo, you
Senator Clint Penzo
Unverified
43:01
have a question. Thank you, Madam Chair. Um, I, I've got several scope bills and healthcare bills, um, and we've, we've spoke a lot over the years on this specifically and, and before, uh, But On several of my bills, there's been requested amendments, um. And for this particular one, it was just we're against it. So to come in and say that we
have issue, issue, an issue when you've given me recommended amendments on the other ones to make it palatable. That is not, has
not been the attempt. The medical society is just opposed to this.
Speaker 94
43:46
Am I correct? Yes sir, we have a hard time figuring out a way to make the bill something that we could live with, and we do try to work with any, any piece of legislation that we feel like can be amended that we can come
out to an agreement, and we have, and oh yeah, got a few, I
Senator Clint Penzo
Unverified
44:07
appreciate y'all. Y'all are neutral on some of my bills, support some of them, have recommended
a. amendments to become neutral, um, and I, and I do appreciate that of this medical society. I just am disappointed that this particular bill, um, Has been shut down. Ever since I've been in the legislature, and it's past time with, in my opinion, for that to change. So thank you. Thank you.
Are there other questions from members of the committee? See none, we thank you for your testimony. We have, um, two people that are signed up for the bill. Nobody else signed up against, um, Shari Beavers. I had my
Speaker 130
44:56
shoes on my feet. Members before you start, I've,
I've tried to get them to tell, ask the people politely in the
hallway to try to tone it down a little bit because it's, it's a lot of it and I said thank you we're, we're trying to it gets a little loud, sorry. OK, Miss Beavers, please stay for
Speaker 133
45:19
the record. Thank you, um, Madam Chair, committee, I feel like this is a little deja vu because I testified before you last week, um, on the floor I built and I stated that I have thyroid issues and, and autoimmune issues, which I manage with no pharmaceuticals
and I did that with the diet and supplements um with a naturopathic doctor at a Northwest Arkansas, and she has certified and I
Speaker 134
45:46
believe Mamie knows her, um, however, today I'm not sharing that story. I want to introduce my daughter's story and May of 2020, she and her husband found out they were expecting their first. They had gotten married the year before, we're extremely excited, bought a house, prepared to um
start their family at 20 weeks, they were giving devastating news that he had high drops. That's high drops, fatalis. I'm sorry. Um, this is normally a fatal condition and Cassian went to be with the Lord. At 28 weeks. Senator
Speaker 136
46:32
Irving helped us be with her in the hospital when she delivered. Um
Speaker 134
46:42
And I still appreciate that. Um, doctors recommended testing, um, every everything that um was on record for them to be tested for because the cause of high drops, uh, varies. There was no definitive answers found, um, they were told that it can just happen sometimes and we actually know someone that also lost their child and then had previous pregnancies and no
problem. But a year later, she became pregnant again with a baby girl and Celestine also went to be with the Lord at 20 weeks. Again Devastation led them to seek traditional help through testing that was recommended and this time they both went through all the recommended testing, and there was still given no answers. At this point, my daughter was having some other
minor issues, so she decided to seek alternative options. Upon our first visit, the practitioner reviewed her diet questionnaire and told her she was anemic. which is a cause linked to high drops. She said that wasn't possible because the prior test showed her iron to be at a good level. He said, you are taking a plant-based iron supplement, which would keep your levels up, but looking at your diet, I can
tell that you have little to no red meat, which um has something called hemi iron, which I'm not a doctor, so I don't understand these things. Um, but no heyarn. Um, which led her to be anemic, severely anemic. Upon his recommendation, she changed her diet and within days, the minor issues that she was um having were resolved and within a month she was carrying our 2
year old grandson, Judah, and he, he was carried full term and completely healthy, just 8 months ago, she delivered her 2nd uh well, 3rd son, but, um, full term and healthy. I'm not here to disparage any traditional doctor test. I feel like, um, um, Senator Penzo mentioned there's a time and a place and I do believe that. But I'm asking you to support this legislation to open up options for people who need to
seek another alternative care practitioner. It appears that we have a healthcare crisis here in Arkansas and I know maternal health is a question. And my daughter would be listed as a problem, but in this instance, she was able to be cared for in another way, and I just ask your consideration on this bill. Thank you. Thank you.
Are there any questions? Um I appreciate you coming before
us and testifying and happy, happy for the successes. And that was, it was an honor to be able to help you, Cherie. OK. Summer Herod. Hello, thank you so much for letting me
Summer Herod
Unverified
50:07
be here. My name is Summer Herod. I'm coming to you as a new Arkansan. I am a Texan born and raised, very proud, but I love the state of Arkansas. Uh, my family and I've been here
3.5 years, but before that I have lived kind of all over the United States happily. It's been fun. I have lived in Ohio. I have lived in Michigan. I have lived in Kansas. I have lived in San Francisco and most recently New York City and every single place that I've lived, I've experienced healthcare. Because we all do and I've experienced very different kinds of healthcare, um, And I've seen pros and cons of all of them. What I want to come
today to say I am for this bill. I am not against medicine, traditional medicine, but I am for people for the people of Arkansas and that we have the right to have information. I think we could all agree on that. We should all have information. All these doctors here, I think they want us to be informed, um, and then with that information, we should have the freedom to use that information for our good or our benefit, and it should be both traditional
medicine and naturopathic medicine. Um, When I lived in New York City, uh, I saw A very sick city. I lived there for a long time. I wasn't a visitor in these places. I lived a long time. And I saw a lot of sickness and uh I saw No way forward for most people. Then moving to Texas, a lot of people, there's a lot more freedom there to have information and to do with, do with it as you please. Now I'm
here, I chose Arkansas. My family and I did because it is a very awesome free state. I'm a homeschooler. I like to see that there's freedom for the people, and that's what I'm here to say. I hope that you guys will be for this bill, I see that there are things that need to be done. I have the bill in front of me. I've read it back and forwards. Many people here are very smart in Arkansas, very informed, um. highly educated, myself included, my husband included, we're very highly educated people, um. So I've read this bill, I see, I listen to what's being said by
Senator Penzel. I see that there are issues that are being raised by the doctors here. That's good. This is good. This is, this is republic, right, to discourse with people and uh you're not above us, we're not above you, we're together in this, in this state of Arkansas, and I'd love to just see it be even more free and just to continue in that and work out the things that need to be worked out because there are things that need to be worked out, but let's move forward with this licensing of naturopathic. Medicine just for more freedom and information for the people.
That's all I have to say. All right, thank you. Are there any questions? Yes, Senator Hill, you're recognized.
Senator Ricky Hill
Unverified
53:02
You mentioned the state of Texas. Do they offer this?
Summer Herod
Unverified
53:05
Well, I am not a naturopathic, so I can't say that they do, but there are people, many people like Mamie who will tell you I know because I went to one. Now I, I had my son with a traditional medicine. I had a cesarean section and everything was great. I had my doctor, wonderful, loved him, but I happen to love natural medicine as well, so I was able to meet a lot of people who practice in the very same way that it seems
like Mamie is saying people practice here, saying we're not licensed, but we can do this and that for you. And so I had freedom. I will say this. In Texas, you might not be able to be licensed, but it was, there were a lot of naturopathic. Practitioners who would say we're not licensed, but there were tons, they were everywhere, everywhere. If we had to fill a board, we would have done it like that, and I love Senator, that you're like, hey, we can, we can change that language if we have to, but I think I will tell you right now there are 12 people. There are probably
11,000 people in Arkansas who could fill that board. I'm serious. There are so many educated people in this state and educated in naturopathic medicine who are not practicing illegally but who have the same credentials that Mamie has, but I have to keep them under wraps. I guarantee you, if you have to make it smaller, fine, but I could guarantee you that there are 1000 people here. I have several friends who live in northwest Arkansas. They're everywhere. I appreciate that, but whenever you say I know
Senator Ricky Hill
Unverified
54:21
there's plenty, unless you show me facts, I can't look at that. I understand that, but can't
Summer Herod
Unverified
54:27
that be something? Yes, but can't that be something that you could work through because they're not showing their face today, does that mean they're not here, or is it something that can be worked through. I can show some
people if they could come and show their face. Well, thank you, thank you. OK, thank you. Are there other thank you for your testimony. Are other questions? All right, thank you. I
just have one quick question on page 3. When you, when you and maybe Senator Pence I needs
to say this, but I think more Mamie would probably answer it because I think it's more specific to practicing. When you say naturopathic therapeutic medicine means use of one or more of the following physical agents. Um, by the by by hand by mechanical means and you've list a bunch of things here on page 3. And you air. Um
That you have electromagnetism and colon hydrotherapy. I'm assuming that that's by mechanical usage, are,
are these instruments that you use, are they certified under CIA. Are they, um, Are they, are they regulated? Are they, I, I, I don't know anything about that in any kind of mechanical means that you're using, so I just know whenever I
dealt with like tattoo legislation, you know, we had to be very specific and make sure that we had Clia certification on any instruments that are used on the human body because of prevention of infection and things like that. So I don't see any of that in this, that like
that would be a requirement. If you are licensed and you are using instruments in that manner. And, and I think if this is a brand new area that we're treading that that would be
pretty important. So are you using, I, I would assume you're using instruments. Well,
Speaker 48
56:35
I'm, I'm not currently doing any colo hydrotherapy or electromagnetism, but an example of electromagnetism might be like a TENS unit, which is commonly used by physical therapists and chiropractors to deal with pain, um, colon hydrotherapy, we have this available in our student clinic. I believe it was a CIA certified, I, I don't know those details though, and we wouldn't have a problem with that being part of the language.
OK, yeah, well, and again, I'm I'm just, I think I see a lot of Things and
issues that I have, you know, with, with it, so, um, but I, I appreciate those answers because I think that's, that's just really important, you know, because you don't want to spread staph infection and
Speaker 48
57:18
things like that sanitized and yeah, that's so we would, you would, but this
is a new different new areas, so you would have new, you would have to have probably code sections for that. I'm pretty sure that a lot of that is usually addressed
in rules, is it not? I mean, it has to be in, I mean, I, I would think you, I know. am I dealing with even just a tattoo artist in that industry, we had to have specific language just for the, you know, for the, for the instrumentation and it was there, you know, they brought it to me because of huge problems where people were not, were using instruments that were not, uh, you know, sanitized properly and, and, and you would have the health department would need to then issue certifications for your
practices to certify that that was the case. So I, I think that's an important part that's missing in the bill. Any other questions? Peyton. Thank you, Madam Chair. Uh, I
Senator John Payton
Unverified
58:16
guess my question is, I think it's obvious this is happening. The treatments are taking place. We have no way of identifying those who are Greatly trained like the lady at
the end of the table versus somebody that just Got granny Clampit's recipe book and hung out a shingle. So, I mean, if we start To form some regulation here to try to Have people who are practicing this meet certain requirements. I mean, I guess my question is, are we, are we trying to say that this bill Creates The, the world of naturopathic
medicine or regulates the world of naturopathic medicine, because it seems to me
Senator Clint Penzo
Unverified
59:12
that it's already happening. I think you make a great point. I mean, there's a consumer protection component
to this bill because people identify as whatever they want to out there, uh, a lot of them are practicing. I mean, in other states, maybe can practice at this scope. In Arkansas, she's she's practicing at this scope under a different license, um, you know, it's, uh, and, and this would allow her to be in the middle. She still couldn't.
Practice to her full potential because I've restricted the bill and You know, took out prescriptive authority, surgical procedures, things of that nature. So yeah, I mean it, it, it does prevent some of the people just seems to me that the people that are more
Senator John Payton
Unverified
59:51
apprehensive about it. I would feel more comfortable if we had a board and some regulation over it. I agree. I But you are creating it in
the law. I mean, that's, that's what you're trying to do. You're trying to create it in the law,
whether or not people are, I said you, you are creating it in the law. This is a creation. This is a new thing that you're creating in the
Senator Clint Penzo
Unverified
1:00:24
law, but there are people out there today. Right, so we are creating parameters within the new in the law that that only allow doctors to be called naturopathic doctors because they are doctors. They have been to school and received their doctoral training and they just can't practice his
naturopathic physicians in the state today, and we need to, in my opinion, allow them to do what they're doing in 26 other states. Senator Hill, you're for a question. Senator
Senator Ricky Hill
Unverified
1:00:50
Penzel made a comment a while ago, and I agree with him that On Radilogy if they're going to order X-rays or whatever, it's going to be done one way or the other, whether it be from the PCP or whether they do it themselves. And you know, so it didn't see much of an impact as far as insurance cost goes. Is there anyone here from the insurance side that can actually kind of allude to this.
Uh, I'm not sure if anybody wants to volunteer to do that, but if there is
somebody that wants to respond to that question on the private plane or I think Medicaid, I think is here DHS. I mean, There's a fiscal, there is a potential fiscal impact maybe for, for them. I'm not sure if they're here and they want to speak to it or not. If they're not here and won't speak
Senator Ricky Hill
Unverified
1:01:34
to it, I will assume that Senator Penzo is correct. Is there anyone here from DHS?
They're outside. They should have been in here. Let's go
ahead. I'm through. there OK. All right. Anybody from the private insurance side of things. The, OK. All right, no further questions, you'll recognize the
I, I personally OK. Hi Yeah, you don't have a question. The question is fiscal impact statement for Senate Bill 117, and you don't have one. OK, but we can request one, is that correct? OK. I'm officially requesting one. All right. on your clothes for your bill.
Senator Clint Penzo
Unverified
1:02:47
I don't I don't recall getting one on your maternal health bill, which I'm sure
had a staggering physical impact, but um I will like to close here. Uh just a point of clarification, um, Peyton mentioned
something. I just want to clear up that, uh, It wasn't specifically the Medical board that declined adding them under. It was the I hate to use the word hostility towards naturopathic physicians, but the fact that there wasn't
an attempt to amend the bill, um, they've tried to kill it every session. I didn't think it was right, uh, to continue forward with putting naturopathic positions under. that board because it, it just, you know, I mean, I, I remember when osteopathic physicians and allopathic physicians didn't like each other and osteopath or uh Your DOs were considered not real doctors. Uh, now they're Equal partners in the in the medical society as far as
representation. Um the uh Nutrition. I just want to point out that I'm not saying doctors don't understand nutrition. I'm just saying that the naturalopathic physicians have substantially more training when they're in. School. Um, so I'm not saying that all doctors don't continue their education and look into it. I'm just saying they, they're, they're, they understand diet and those types of things a lot more. Then they focus on drugs.
Medical doctors focus on drugs. Naturopathic, um, and, and to say that allopathic doctors are practicing naturopathic medicine is that, that, I mean, we don't have naturopathic medicine in the states, they can't really be practicing naturopathic medicine, and they shouldn't be. They should be doing what they do and are currently are trained to do. Um. This will attract doctors to the state. There are people that I've spoke to from other states that would
love to move to Arkansas and set up shop. So that will bring people into some of our healthcare deserts in the state where we don't have uh allopathic or osteopathic doctors. So there will be care, additional care providers in the state, which is a good thing for everybody, especially rural Arkansas. If you remember, uh, Senator Ballinger and I worked on this. He was excited when I filed this bill, uh, he went to Arizona, I believe, for his. cancer treatments, um.
They had a naturopathic physician on staff that focused on Nutrition The medical doctors, the allopathic doctors are the ones that focused on our chemo, things of that nature. They work hand in hand in Arizona. It's not a replacement. It's not, you know, it's a, it's, it will improve holistic medicine in this state, uh, you know, something, I don't know if I've talked about a lot, was in, in my previous roles, um, my long-term goal was to be either a, uh
osteopathic or a chiropractic doctor. I mean, that was like my long-term goal. So I was, I've almost, you know, knocked out most of my ATC stuff, my dietetics training. I never, never did finish those degrees, but, uh, you know, finished up the degree in physical therapy, uh, trained under a manual therapist, uh, decided to go uh to get massage training based on what I learned from the, the manual therapist and just a quick story before we close. I was working on a patient one time. And we were at the hospital and
I was working on her neck and I found a vertebrae that was a little out of whack. And so I did some soft uh mobilizations to, to the vertebrae and all of a sudden she said, hold on a second, my, my fingers are tingling and you need to stop. And I was like, oh shoot. And then I got to thinking, what's it feel like? She's like, well, you know, when your foot falls asleep. And I was like, yeah, the feeling when your foot's waking back up. The tingling, the pins and needles, and she said, yeah, and I was like, so, so we moved on
to some different things and then by the end of the thing, she said, this is the first time I've felt my fingertips in years. Now, I'm not saying I'm Awesome at what I do. I'm saying I was the right guy at the right time with the right issue and the right training. The things I learned from the, the manual therapist. She'd been a chiropractors, doctors, neurologists, nobody could figure out what was wrong, and I just happened to be the guy that stumbled onto it. So it's not a matter of anybody replacing anybody. It's it's integrative medicine. It's holistic
medicine. It's bringing every aspect of it together, and we're missing a puzzle piece and we'll never have great health. here in Arkansas, if we don't allow them to come practice in Arkansas. So, you know, a lot of times these scope bills are turf wars and protectionism and, and uh this, this isn't about safety. This, this bill will create safety. It will line out who's an actual doctor and who's not, and, and allow them to practice almost to their full
scope, so I would appreciate a good vote. And I'll, I'll make a motion
to pass. So like, there's discussion. Motion and and second discussion have a discussion. I'm just Senator Love, you recognize.
Senator Fredrick J. Love
Unverified
1:08:15
Thank you, Madam Chair. So just for clarification, All right. Cause, cause I'm confused right now, uh, did
Speaker 169
1:08:28
You requested a fiscal impact, so do we have to have a fiscal impact to pass the bill out. I'm just wanted to
Senator Clint Penzo
Unverified
1:08:37
clarify. In my opinion, we don't have to have the fiscal impact yeah. clarify with the
So no, our rules do not prescribe that we have to have a fiscal impact, but I've requested a fiscal impact, um, I personally have requested a fiscal impact from DHS. So, I, that's for me as a, as a member, but no, there is no, there's no rule that states that we have to have one before a bill is is voted on. OK, that's
Speaker 174
1:09:32
that's the only clarification I needed. Thank you
Discussion Senator Hill. Listening to the testimony
Senator Ricky Hill
Unverified
1:09:43
today, there is no doubt that there is a place. In the medical field for this because not everyone's body accepts medicine, the same medicine, the same way. What works for me may not work for you or vice versa. So I do think there is a place for this in the field of medicine for those people who need another care or want alternative care for that. And so with that being said, I would actually like to see this following the medical board. If they, if they have major concerns with their issues.
Let's regulate it and let's uh let's let them get knowledgeable on this type of medicine. I know they told you they may not like that or may not want it or were not interested. But as a legislative body,
we can, we can say that. Thank you. Uh, no, there's no,
Senator Clint Penzo
Unverified
1:10:32
this is discussion only. I'm a member of the
committee, so one moment until you're recognized and Senator Payton, I have him before I can recognize you. Thank you. Am I recognized? I just
Senator John Payton
Unverified
1:10:46
recognized you. OK, thank you. Thank you, Madam Chair discussion. Well, it, it kind of breaks my train of thought when there's all the tension in the room, but uh when I first read this bill, a week or 10 days ago, I mean, I thought this is crazy. And then I hear the testimony and what would be crazy would be to continue where we are. With no Requirement For the education and the regulation of this industry. I mean, I think that would be
crazy for us to just stick our head in the sand and pretend like it's not there and it's not working. And, and I know that. There's got to be members of the medical profession, medical society, or whatever. That have seen the benefits of this and, and I don't know why. They would have such animosity towards it, but I think I've seen in this meeting today that I understand why you didn't put it under the medical board. I would hope that it could be under the medical board, uh,
because it's more efficient that way, and, and it should help the people with With uh Concerns about it, but uh I think this is a good step forward. I'm going to vote for the bill and, and uh hope that it brings somebody to the table on the other side. When they realize it's gonna pass if they don't get involved. So I'm voting for it. Thank you. All right,
Senator Penza, you're recognized for discussion. I mean, it's. Thank you, Madam Chair.
Senator Clint Penzo
Unverified
1:12:19
Um I, I had looked at putting it under the chiropractic board. Or the acupuncture board. Because those would be more friendly boards, but Acupuncture, I didn't feel it was right to put. Doctors under acupuncturists, chiropractors that hadn't had a time to kind of play phone tag with some folks over there and haven't been able to pin them down because I just recently amended it. Um, I might think it might be more appropriate.
To put chiropractic and naturopathic medicine under the same board, um, I was reaching out
to see if they were interested. We've got allopathic and osteopathic under the medical board,
um, this, this is more closely related to chiropractic. They do manipulations, mobilizations. They also chiropractors are big into uh supplements and herbs and things like that, so it dovetails better with chiropractic medicine in, in my opinion, um.
I will be happy to discuss this further and consider amendments to the number of people. I'd like to get it out of committee today. I can amend it on the other side, um, if you all want to have some further discussions on the best place you'd like to see the board set up. I know we don't, we like to kind of consolidate boards and that's kind of the the feel of the legislature and that's why I put it under the medical board before it was because I was trying to make this as easy and smooth as possible, but I think there will be, we would have to put Naturopathic.
physicians on the medical board, and they, they are not going to like that. So I think the chiropractors will be a lot more. Friendly towards naturopathic doctors and like I said, it's, it's more comparable to that type of medicine. So, um, I, I'd like to maybe consider that at
some point, discussions on that if you all would like to do that. But uh Look keep. Are you? No, I'm but I
would like to pass the bill today and have have some discussions with y'all on
how to do that and make any possible
amendments on the House side. Um Well, I'm going to discuss now. Um, I, I think there should be some licensure for, for you. Um, I actually don't disagree with you, Senator Pino. I don't, I don't, I think, you know, chiropractor board is probably the better place I'd have, but I again have not had discussions with medical board, chiropractor board. I couldn't speak to that, but I, I, to me, I think there's
a place here for this, um, this is a, this is kind of biting a big. of the apple, and I think my comfort level would be to refine the language in the bill, make sure we have really good tight language and make sure that we're we're, we're setting this up right from the, from the very beginning and making sure it's done the correct
way, uh, and, and so, you know, I, I think for me, I just, I've I've outlined where my problems or issues are with the bill. I think this,
once it gets out of the Senate committee, I mean, just be honest with you, I don't, I don't know because I have no idea if there are that many people that have that level of degree that you've prescribed in the bill to create a board, and I think that's a real concern if like just the functionality and how, how we could try to even implement the bill. I think you'd run into problems actually. And I think that's, I think you would run into problems potentially finding those people to fill that board and um so I I think
Your idea of actually trying to work with a chiropractor board or something might be a a a better path for you, honestly, just for implementation purposes, but, um, I do think like the certification, I mean, you, you're creating something new and so I, I really believe that you need to have a lot of that language, you know, in this code section if you're, if it's new code section as it deals with naturalopathic medicine, um,
And, and, and how that that interacts with the health department and how that's being regulated at the health department level. Um, because we have that and it would be consistent with, um, any, any other kind of practicing, I think. So, um, and I'm, I don't know if you would have to add that that into different parts of the code where that would be applicable, that would be a health department issue, um, but that's, that's one of my concerns is just making sure that that language. be tightened up.
I, I, I honestly think that that's where I'm at on it. So that's for, so that's just discussion from my end, um, um, other just discussion before we take a vote, um, let me get to Senator Hill, and then Senator Penzo, Senator Love, OK, I've got a list. Senator Hill. Thank you. Senator Penzo just For the record, As chair of
Senator Ricky Hill
Unverified
1:17:26
another committee, I'd like to see things fixed in the committee we're in. That's
just my personal opinion. I like to see them fixed here that way we do have control and say so on making sure things are the way we all agree, whether it's me and you look each other in the iris. Just just agreeing on something. I would like to see it a minute fixed here. I do support your bill. that will continue on even if we pull it down if you decide to pull
Senator Clint Penzo
Unverified
1:17:56
it down today. I will, I will pull it down if I can get a guarantee from the chair, we'll hear this after lunch after session today and I'll get the amendment.
Oh, I don't, I don't know if you're going to have time to visit with a chiropractic board and all
Senator Clint Penzo
Unverified
1:18:11
of that I don't know that we need to visit with them if this committee decides that's where we're putting it, that's where we can put it. So no, I mean that's how this works. This
is back and forth, um, I, I can't guarantee that it's going to run this afternoon. I, I, I
won't because we have so many bills on the agenda, but, but I will guarantee that we will run it as soon as you
can get it rescheduled, but I think a lot of people have a lot
of, uh, you know, There there's a lot of people around this table that are interested in trying to help. I'm not sure if I can commit their time completely dedicated to this issue right now for you and
then be prepared to to run with it this afternoon. I can't commit to that, so. So thank you. I'll pull
Senator Clint Penzo
Unverified
1:18:55
it down and we'll, we'll run it at another time. OK, thank you. Thank you. All right. Um,
I'm sorry, Senator Love discussion, but we pulled down the motions now that Senator
Senator Fredrick J. Love
Unverified
1:19:08
Penzo pulled it down, but I, I will say that I'm in agreement with you. I mean, we need to actually, if we could put this on special order for the next time that we so that we can get this bill out because I'm, I'm in, I'm in
Speaker 189
1:19:20
support, so if we could do that, yeah, and I just, how
about we'll just do special order for Monday, next Monday. OK, that'll
Senator Clint Penzo
Unverified
1:19:26
work. Thank you. Thank you. We think. Senator Hill, you're recognized. OK. With the chair you recognize.
Senator Ricky Hill
Unverified
1:19:40
Guest speakers that came in the guest people, so they don't have to come back so they'll know that we don't have to
hear the testimony again. Yes, that, yes, yes, thank you, that's a good point. Um, so thank you all for your testimony today. Uh, I don't think it'll be necessary for you to come back and testify again, and we we've got, we've got you on record and we can go back and watch the video of that as well. So we really appreciate you coming today and uh thank you for being here with us. OK, thank you. um. For us
Um, OK. Also, in the meantime, DHS, if you
could look at this bill and try to get that information back to us as members of the committee and to Senator Penzo, that would be great. Um, Senate Bill 118. Do you want a drink of water first.
What So I'm fine. Do you have
Speaker 195
1:20:54
people here? No, no, no, no. Oh OK. OK. Well, just hold tight.
Speaker 57
1:20:59
All right, thank you. If you'll just state
your names for the record, you're recognized. Pope Gillison. I'm sorry, can
you pull that mic up to your, I'm sorry, we have a hard time hearing.
It's really loud out there spoken most of
Speaker 197
1:21:23
the time. OK, just speak right into the
Speaker 198
1:21:29
mic then. Hope Gillison Gillison. All right, Amin Olani A M Y N. I'm Lonnie A M L A N I. OK, thank you.
Senator Clint Penzo
Unverified
1:21:40
Please proceed. OK, um. Senate Bill 118 uh amends the
definition of audiology. Um, I've got two folks here that know way more about audiology than I do. So I'm going to let hope kind of lead off and,
Hope Gillison
Unverified
1:21:56
and uh As I previously stated, my name is Hope Gillison and I have worked as an audiologist for 23 years. I earned my doctorate following 4 years of undergraduate and 4 years of graduate training. Throughout my career, I have served as an adjunct professor at the University of Arkansas, a supervised supervisor to doctoral students from Memphis,
UALR, and Missouri State. I retired as assistant chief while also serving as acting chief at the Veterans Healthcare Center of the Ozarks. I was the only cochlear implant audiologist for the state of Arkansas for both Little Rock, VA, and the VHSO until my retirement. I've been deeply involved in advancing patient care during my career. I served as a traumatic brain injury committee vestibular and auditory related to blast injuries, tinnitus
management, working with mental health, and I also served on the the fall Committee for Balance vestibular for your geriatric care at the VA. Post-Federal service, I established a cola plant program at an ENT center and additionally, I have worked with the Department of Defense audiologists under the Joint Defense Association and have held Multiple physicians, both state and nationally. I also served as a point of contact for Senator Bozeman on the Veterans Affairs Senate floor. I currently travel
the United States for a veteran population serving them for compensation and pension examinations. I'm here today to speak to the benefits of the SPF 118, this legislation streamlines the referral process by eliminating unnecessary visits that result in long wait times for patients. This bill does not provide financial gain to audiologists, rather, it ensures patis and veterans receive timely, coordinated and effective care. Under SB 118 audiologists would be authorized to order necessary scans and blood work when
referring for additional specialty care. This does not infringe upon physicians' scope of practice, but ensures that when a patient arrives for a consultation, their physician has the critical diagnostic information needed to move forward with Evaluation and treatment without further delay. Audiologists are the primary providers in diagnosing asymmetrical hearing loss, cochlear implant candidacy, conductive and mixed hearing loss, postal tell tinnitus, unilateral tenantitus, and vestibular balance
disorders. Our evaluations are often the first step in determining the need for further medical intervention, diagnostic imaging and blood work are essential tools for a comprehensive assessment, allowing the physician to make a surgical and treatment decision. In the federal health care system for community care, veterans routinely face wait times of 30 to 60 days or longer for specialty appointments, delays in obtaining required diagnostic tests only compound the wait times, leading to avoidable suffering and reduced quality of care.
SB SB 118 ensures that by the time of patience seeks additional specialized care or a specialist, all necessary testing has already been completed, leaded to faster diagnosis and more efficient treatment plans. This bill is a common sense as it's prioritizes patient care by reducing unnecessary delays resulting in improved healthcare services. This bill does not infringe on physicians scopes or hearing instrument specialist scopes. This bill strictly puts The patient first in their healthcare first.
OK, thank you. Um, I, I have you both signed up to speak for the bill. I do have somebody here to speak against the bill. So what I would like to do is, uh, go ahead and let somebody speak against the bill, and then we'll go to the, the person you have speaking for, but you can just stay right where you're seated, sir. Thank you so much. Um, thank you for your testimony. Are there any questions? OK, see that I'm gonna have um Lance Manning.
is here to speak against the bill if you'll come and identify yourself for the records.
Speaker 203
1:26:02
Got you. Thank you. There you go. Good morning, Madam Chair and Vice
Speaker 204
1:26:06
Chair Wall was hoping I worked together for a long time, but she didn't think we'd be sitting here together today, so we understand collaborative care and actually had a great relationship professionally. We worked together up in Springdale for a long time. Um, as I said, my name's Lance Manning. I'm an ear, nose and throat physician and surgeon and he just said Senator Penzo's district. Sorry, say it one more time. Say that
one more time and just speak right into the mic. I
think they're asking who you are, where
Lance Manning
Unverified
1:26:35
did you come from? My name is Lance Manning. I'm an Arizon nose and throat physician and surgeon and Senator Penzo's district.
Speaker 204
1:26:42
I am actually a graduate of Bentonville High School when it was a small rural town many years ago, and then after spending 4 years down in Little Rock and 5 years of too much sun and sand in Rochester, Minnesota at Mayo Clinic came back to care for our community and our Kansans.
Um, first and foremost, I've worn many hats as is hope, and I can tell you she's, she's extremely qualified and she, the training she has and the experience she's had nationally is really rare. That's, it's unusual. Her experience with the VA and that health care system is is really extensive. Um, she ran our cochlear implant program, but I can also say this, she's not the standard for Arkansas. She's at the very top of that standard. Um, to clear the air with regards to The previous bill
I actually personally have a very holistic approach to the practice of medicine and surgery and we implement nutritional supplements for some ear, nose, and throat disorders as well as recommend dietary therapy, so I've got a healthy respect for all of our colleagues. I'll say that when we do that, we want to do that obviously when when it's appropriate and I agree with Dr. sorry, Senator Penzo's comments about everything having time and a place.
Um, after returning to Northwest Arkansas after spending you know college and then 4 years down here and 5 years and 15,000 hours of training at Mayo Clinic. I Start a clinic and we've employed a number of master's level and doctorate level audiologists over the years who had the pleasure, as I mentioned, working shoulder to shoulder with them. I'm super familiar with their scope of practice and their training. And I have a deep respect for
them. Um, but to get to the heart of the bill, I want to address some issues that I think surrounding this bill as well as some issues that have been the same discussion because the same language was used in Maryland, and that is the only state where similar language in law has been codified, enacted, and codified, and actually the governor of Maryland has since asked the legislature there to bring it back and limit the scope of this. Apparently things can be enacted
in Maryland without the governor signing off if they give it a appropriate period of time, but in any event, um, with regards to that discussion, this has been called a modernization of the practice standards, and I think some of the things in here are, but I think some of them also are an expansion of practice, particularly the definition of practice in the bill SB 118 says to evaluate, diagnose
manage and treat and that's traditionally language that refers to the practice of medicine. Um, when these terms are used, And other health care occupations, we typically will limit them or qualify them and also have requirements that are relevant to their level of education and training. The type of training for the evaluation and management and treatment of these comprehensive
things and the and the diagnosis that you often find when you order the tests and the imaging and the blood cultures and these things, not All and frankly not many audiologists have had. Um, Certainly when you compare the curriculum through that 4 years and sometimes I'll do kind of an intern year afterwards to the years of training and experience to be able to diagnose complex medical conditions, um, it's, it's, it's not the same, and I
think audiologists do a great job with what they do, and I think there are oftentimes very caring and very well meaning and and they're a great part of our team. I just think this bill has written Takes and and goes beyond that and so what we're suggesting are some limitations to have as Senator Penza put it, have people in the right time in the right place. Um There have been discussions with This language nationally with
regards to providing access, the reality of it is in Arkansas and I looked actually, it's interesting what you can do with AI now. Look, and compared where all the audiologists are. Their primary practices. With regards to population of the towns as well as to their proximity to ear, nose, and throat surgeons and other doctors, and very rare is it that an AUD doctorate level audiologist practices in a municipality that is small, and the reason is because the
independent ones, you got to sell enough hearing aids for them to support themselves, and you've got to have a certain population to do that, right? So while that has been an argument. In some places I would say that honestly if looking at the map, and Google it yourself where the audiologists in Arkansas are, it's not in those places. If it is, it's rare. Um Lastly, you know, they are provisions, particularly in section 1 to be that, uh,
proposal IDL to conduct health care screenings, remove foreign objects in the ears, obtain cultures, blood works, non-radiographic scanning and then radiographic imaging, I think the wording of this proposed legislation. would allow audiologists to make the first medical diagnosis and, and sometimes that's OK, and frankly, sometimes it's not because many of the presenting symptoms of hearing loss, balance disorders, etc. can be
from a tumor that can be from a complex neurological or autoimmune disease, and the difference in the delay of those diagnoses can be really serious for patients. I think you all can respect that. So a couple of
Lance Manning
Unverified
1:32:57
clinical examples just to show you what I'm talking about. So in our office we've got
Speaker 204
1:33:03
a CT scanner. What this bill would allow, would allow, frankly, imaging and audiology office, um, if they so chose, and I
think most people here would be judicious and use this stuff appropriately, but If this allows for it to not be used judiciously. We have to address that. So you have a CT scanner or you get a CT scan of the temporal bone, the area around the ear, and there's fluid when the master was a bone back here behind the ear. Sometimes it's nothing. Sometimes it means that, gosh, you had a cold on the flight and if you've built up the slough behind there, you know, but sometimes when you see fluid in the mastoid alone as inflammation, which looks the
same on a CT scan, you have to know that while this patient has uncontrolled diabetes. This patient is on autoimmune medication, has a suppressed immune system from transplant medications. There's a variety of laundry list of diagnoses that you have to consider. And it takes a lot of years and a lot of experience to make that list. So, What We I'm a proponent of is not doing away with this totally. It's adding language to clarify when it's appropriate for a licensed audiologist to have the ability
to address conditions that are within their training. And not to be construed to the practice of medicine as a physician. To eliminate restrict scenarios. under which a licensed audiologist in Arkansas can order cultures, blood work, and other medical tests. And then modifying language to clarify the ordering of culture's blood work and medical tests that does not include the reading, interpretation, or assessment of the results of these tests.
In, in summary, I think that audiologists are a vital part of our healthcare team. They're a vital part of my team, depend on them every day. But I don't think that the clinical training Includes a necessary didactic and clinical experience during that. To justify the privileges that are listed in this bill as it's written. I want to close by saying that again the comments by Senator
Pennzo and several others that there's a time and a place for different providers in healthcare in Arkansas, and I agree with that. I just think that this bill without changes, does not have audiologists in the correct place. While Senator Penzo said the last bill is not about safety. This one as written is. Thank you. Thank you. Other questions, Sinder Hill, you have a question? Thank
you for your testimony. Yeah. As someone who's worn hearing
Senator Ricky Hill
Unverified
1:35:51
aids for 57 years and a dad who wore them for 93 years and a great grandmother who wore them for 89 years. I think I understand hearing issues. I think what we're looking at is some minor things that they can do. I'm gonna use a cell Myself as my 90 year old dad at the time in a wheelchair took him for a minor hearing aid. Checkup and stuff and just in a wheelchair, I have to take off work. I have to cancel my appointments to take him there. When I get there, they say I could do this, but I can't.
This is simple. I have to take another day. And take a 90 year old to Little Rock. I live in Cabot. I'm not in a small town like you like you were referring to, and so we do have a decent population. Yeah, so I have to take another day's off work to take in a cancel more appointments, and you cancel appointments, you know what that's like. It's kind of like going on vacation when you come back, you've got to get caught up. And so for something that could have been done locally, a minor procedure. I have to take 2 days, cancel appointments to take him there
to have it done that take that took about
5 minutes. I'm Senator here. which procedure are you referring to? This one was was an ear issue with some wax that built up in a bad, you know, certain spot in the
Speaker 204
1:37:05
ear. Yeah, actually I think that we readdressed this earlier, um, and I know that, uh, Scott Smith had been in conversation. That was it was previously in there and actually I don't I don't have a problem at all with audi yeah, well, it's a plus
I totally can relate to that and we actually don't have a problem with the audiologist cleaning room and then doing things like that. The major issues we have are with the ability to take and provide the initial diagnosis, but ordering blood work. ordering cultures, ordering imaging, that's really where I think we get outside the guardrails. Thank you. I just want you to know there's
Senator Ricky Hill
Unverified
1:37:43
more to it than just going to see your ENT. Y'all have a
vital place, don't get me wrong. Yeah, 100%. We
totally agree, but there's also times when people have to do things too and we're just suggesting to put the guardrails where
Speaker 204
1:37:59
they need to be and as written, don't feel like that that's where they are. Thank you. Are there any other
questions? Senator Penza, you have a question. Thank you, Madam Chair. I just have
Senator Clint Penzo
Unverified
1:38:12
a question, Doctor Manning. How, how confused were you when I came up and asked you if you're going to sit at the table with me today. I was a
Speaker 211
1:38:20
little confused. I was invitation. I was told you
Senator Clint Penzo
Unverified
1:38:24
were here to speak and I thought they said for the bill, so I, that was before the other
folks got here, so it's kind of funny when you sat down, I started laughing there been lots of surprises today.
Thank you. Are there any other questions from members of the committee? Right, I
just, I thank you and um I I I just I have a question. In the way the bill is written
on page 2, it says that they're, um, It includes without limitation, removing a foreign body or er
serum and from the external auditory canal. Um, how, how would you do that? It's already. Either one of you in our scope of practice. I know, but could
Hope Gillison
Unverified
1:39:09
you just describe, well, it depends. I've been trained on suction, not every audiologist is trained on suction, so it depends on the audiologists themselves. It depends. I like a lighted curate more than anything. If a patient has hard cerumen and let's say they've worn hearing aids and I think it's going to cause it to
bleed, then I'm going to have them put some oil in it and come back if they need to. If not, I'll do it right there with just the lighted curate and remove it. OK on
the need for it, correct? OK, so, but that's currently what you can already do, ma'am, OK, but do you, but you use an instrument for that. And so in section C, it says that it does not include surgery using an instrument. It's not surgical. Well, here, but here's the problem, it can, it can become surgical, uh, it can become
surgical. I mean, I, I have a little boy who got Henry one day and shoved a pebble in my, his best friend's ear. OK. They brought him, you know, to my husband, who's a primary care physician. He did not feel comfortable trying to remove or extract that little pebble from, you know, his little best friend's ears, we had to send him to a surgeon to have it done. So that That's an example of where there may be a conflict in the way
that this bill is written, uh, in my opinion, because language matters. And so, uh, because down here you say because that could be absolutely considered a surgery and it and it was a surgery and it escalated from, you know, a surgery, a removal into a surgery right there, right then and And then got, had to be sent off. So, and you are using an
instrument in that case. And so I There may be for me there's, there may be a conflict in the way that's written. So I just, I wanted to ask a question about
Hope Gillison
Unverified
1:41:08
that. May I ask, may I say something? Um, so it's not any different than a lot of things we do, so like he said, we work very well together. A lot of audiologists know their physicians, and so even if you're in a private practice, you're gonna know the physicians around you, but if I remove Saruman and I cause injury, the first thing I'm gonna do is immediately call a physician. I'm not gonna go any further,
but that can happen with any We do auto blocks and we do um ear impressions and ear impression can go blow out and pull on the ear drum, and so it's up to the provider, the audiologist at that time, to know their limits, and so that's gonna be, um, this is already in our scope, but I ethically have to know when to when enough is enough and most of us are not going to injure another patient. Um, usually with wax if it causes bleeding, you can throw Afton in there if you needed to, but
I have never not given a patient to a physician when it's necessary, and that was, then I feel like that's the point of the bill. I don't want to read the radiology report. I don't want to read the blood work. I want to provide it to him so that he can do the miraculous things that he does. And so we're just looking at it as going forward, right, but, but
ordering cultures and blood work testing does give you another avenue for compensation.
No, ma'am, no. OK. And then uh, And sometimes those foreign bodies, uh, like
I said, can escalate into different things. I mean, both of you can comment. Doctor Manning actually
was addressing the question to you. I agree. I mean,
Speaker 204
1:42:49
them removing through and the case that Senator Hill put forth that's in their scope of practice, and that makes a lot of sense and I don't know if the person you went to was an audiologist or hearing aid dispenser they were, OK, so, so that's not something
right that, you know, I think the House of Medicine or as Olaologist that I have a problem with, I just think that as you mentioned, uh, Madam Chair, language matters. And I think that the language that's in here is very broad, and we need to maybe put some work into further define that and put us on guardrails. Well, I believe that Dr. Gillison is 1100% ethical and judicious in the care she provides. I've experienced that for years. Not everyone is, and so the language does matter, and I
think we need to not use this broad-based language that actually elsewhere is already contentious and being brought back.
Yeah, OK. All right, any other questions? Yes, Senator Penzo. Um,
Senator Clint Penzo
Unverified
1:43:50
you'd mentioned, uh, using suction, uh, to get earwax out. So if if that's currently in the scope of her ear wax removal, um, and you're not trained on suction. It's
not within your scope to use suction, correct?
I mean, some, you shouldn't be doing procedures you're not trained to do, correct? Oh,
Hope Gillison
Unverified
1:44:14
absolutely. We, we have ethical guidelines we have to follow and be certified, and if you get, obviously you'll go on probation and then you Face the consequences, and people do turn you in. So
Senator Clint Penzo
Unverified
1:44:26
just because it's in your scope, if you're not trained to do it, you probably should. You're not supposed to do it. Just
wanted to clarify that. That is not supposed to, but some people do. So yes, Senator and that
Senator Fredrick J. Love
Unverified
1:44:37
that was what I was going to bring up, you said something that's in
your scope and then you say it that all audiologists are not trained on it. So that is correct I'm trying to think, well, why is it in your scope if you all don't train on it. It depends on
Hope Gillison
Unverified
1:44:54
the university and where you go. So I even trained in neuroology and so I was trained in section at the university and then trained also by the neurotologist. It just depends on the university and what they provide, and if they can afford the machine, some people don't want to have a suction, they don't have some
ENTs don't have suction. OK. OK. All right, thank you. Any other questions for, for the, OK, thank you. OK, we're moving to, uh, now one
other person that's here to speak for, he's been raising his hand so you can address some of the questions in your, in your speech. Thank you, uh, Doctor Manning. Well, good morning, you're recognized. Just state
your name for the record, and if you could pull that mic up, appreciate it.
Speaker 229
1:45:43
Is this loud enough? Yes, it is. OK, thank you. Uh, my name is Amin Olani, A M Y N A M L A N I. Um Madam Chair Urban, Vice Chair Wallace, and members of the Senate Committee on Public Health Welfare, and Labor. Thank you for the opportunity to speak today. Um, my name is Doctor Omlani. I'm the president of the Academy of Doctors of Audiology, a leading national association representing audiologists in Arkansas and across the United
States. Uh, more importantly, I'm here as a practicing clinical audiologist and as the past program chair of the audiology clinical training program. At the University of Arkansas for Medical Sciences, and I've also worked at other places as well. I'm here today to express ADA's strong support for SB 118, an essential measure that will modernize Arkansas's ideology Practice Act to reflect national standards, food and Drug Administration regulations and
the highest levels of educational and clinical training in the field. As someone who has overseen the rigorous academic and clinical training of doctoral audiology students, I can personally attest to the extensive preparation that these students under. go. Graduates of audiology programs, particularly those from the University of Arkansas for Medical Sciences complete intensive coursework, hands-on clinical experiences and residencies that ensure that they are fully capable of
providing comprehensive hearing and balanced care. Their training is designed not only to diagnose, evaluate, manage, and treat hearing disorders, but also to recognize when a referral to another healthcare provider is necessary. This level of preparation matches and in many cases exceeds that of other clinical doctoring professionals who are already authorized under Arkansas statutes to perform comparable health screenings and diagnostic procedures.
SB 118 provides a technical update to align Arkansas's laws with the US Food and Drug Administration's 2022 final regulations for prescription hearing aids. The FDA has explicitly affirmed that licensed audiologists should continue to prescribe, recommend, fit, and dispense prescription hearing aids independently. This legislation will harmonize state statutes with federal guidance ensuring that Arkansians continue to receive timely, cost-effective care from highly qualified providers.
Importantly, SB 118 also ensures appropriate limitations within audiologists scope of practice. It explicitly prohibits surgical procedures while recognizing audiologists' expertise in non-radi radiographic imaging video autoscopy and cerumen and foreign body removal from the external auditory canal. This last point is critical. More than 600,000 emergency department visits occurred between 2010 and 2019 for ear
canal foreign body removal, enabling audiologists to perform these services will reduce unnecessary emergency room visits, lowering healthcare costs, and improving access to timely care. By fully utilizing audiologists capabilities, SB 118 will help alleviate the shortages, ensuring patients receive the right care from the right provider without delay. Finally, in a state like Arkansas, where there is a documented shortage of primary
care providers, SB 118 is a practical solution to ease health care workforce shortages, particularly in rural areas by passing SB 118, you will help reduce delays in treatment, lower health care costs and improve access to safe, effective ideological care for all Arkansians. In closing, I urge you to pass SB 118. Doing so will ensure that Arkansas law reflects the higher standards of audiological care and the rigorous training our audiology graduates receive.
Thank you for your time and consideration. I'm happy to answer
any questions. Thank you. Could you, uh, I'm sorry, could you say
Speaker 229
1:50:03
where you're from again? Yeah, I am from the Academy of Doctors of Audiology. I practice in the state of Texas. I was here from 2016 to 2020 as the department chair for the audiology
program at UAMS. OK, um, can I ask a question? How many of
your folks, did you play in rural Arkansas. Um, when
Speaker 229
1:50:27
I was here, I believe we placed out of about 30 graduates, I want to say maybe 20%, 15 to 20%. Um, Magnolia comes to mind just outside of Pine Bluff, north of Jonesboro, and then um just outside of Texarkana just south of that, we had We had a place that we have, we had a person go that I can I can recall. OK, thank you. Any questions from members of the committee? OK.
Um, just I again, I just wanted to ask one I, I just really don't want to make sure that your language is correct. I really, really do. Like if this bill passes, when you say you've already are allowed to remove a foreign body and within the current scope, but then down in line 16, it talks about surgery using an instrument and then human tissue, which, which could be part of that, uh which would be
removed, that It does not include that. So I just, I want to make sure we're not messing up something that you can already do. I'm being completely sincere about that in the way that the bill's written. And I'll, I'll just, I'll, I'll, that's probably more a question for Senator Penzo, that, that's just my, I want to make sure they can continue to do what they're currently doing. I think I think that's probably more appropriate for him to
Senator Clint Penzo
Unverified
1:51:51
answer, so, so you you gave the example of the rock in the year for the
Speaker 229
1:52:00
young child and a primary care physician referred it on. It would be the same thing. We look in the year, we determine what we're able to do, and there are some cases, so for example, if there's really hardened wax in the year. There are cases where you will put a ointment in, try to loosen it up and remove it. There are times when that that lotion just won't work and you you'll make the referral to an ENT physician that says, Hey, can you please help remove this? We do that day in and day out. So I work at
Medical City Hospital in Plano, Texas. We are allowed to remove wax. And there are times when we can go in there in our case, we use curettes and forceps, and production if there is a suction unit there that other folks use. I don't use it as much because I'm not as familiar with it. I'm a little more old school, use the forceps and and the curettes to remove things, and there are times when the lotion won't work and I'll say, hey, you know, hey, Dr. Sue, uh, Doctor Dang,
whoever, can you guys go in and remove this, your training is in durabilities are a little bit better, but I've already done my end of the deal and then in making the appropriate referral just that, I understand that, but a
force up is a surgical instrument. It is and
that's why I'm concerned about the language, the way it's written, because it's force up is a surgical instrument, and this says out audiology does not include surgery using an instrument. That's what it says.
That's the language in the bill. And so I'm, I'm I'm really I'm just, it's, it's a a force up is a surgical instrument as suction tool is a surgical instrument. And so So I just want to make sure
Senator Clint Penzo
Unverified
1:53:44
its surgery shall not perform surgery. We're not doing surgery. It's
not surgery to remove earwax. I mean, my, my wife did a great job
this up, I mean, but it also I understand, but removing a foreign body, it's not rocket
science removing a foreign body does require surgical techniques using a surgical instrument. I mean, you may have a bug that climbed in the air, anything and that blacks could build up around that foreign body, and you do say remove a foreign body. And so it's not just ear wax that we're talking. about. It's a foreign body and you're using a forcep, which is a surgical instrument and so I'm, again, if it's, I'm concerned that the way that it's
written is actually may prevent something, so I'm just stating that Senator Love, you're recognized, and then Senator Payton. I,
Senator Fredrick J. Love
Unverified
1:54:41
I think, I think, I think she is correct in, in the, the
chair is correct on what she's saying in in one part of the code. You're saying that you have, you have the um. You can already do it, but this may conflict with that and
therefore it will rule that that it will rule that out just to go back and correct that to make sure that this doesn't conflict with that piece. That that that I I hear I I exactly hear what you're saying. She's
not, she's not saying that you're, you're Yeah, let me get this right. She's not saying that you're saying that you can do surgery or you cannot. What she's saying is that this is a surgical instrument and in this in in
what she's reading right now is saying that you can't use that. That's got a conflict with that other piece of of your scope and so therefore it may voided out. So in order to just to get everything cohesive, you might need to go back and correct that. That's all she's saying. She's, she's not, she's not saying to do away with the bill. She's just saying make sure that the language is is together so this will not
void out that part. It will not nullify that part that's already in your scope. Uh, you get what I'm saying? Because this may you pass this penzo as it is, it may nullify that part of your scope. That's, I'm, I'm telling you, but if, if you all want to go ahead and pass it, we could pass
Speaker 245
1:56:25
it like that and then when it nullifies it, then we'll be back at the same spot. Thank you,
Senator. I hear you. Thank you. Well, I don't know if surgery is defined
and I'd have to look at the definition
Senator John Payton
Unverified
1:56:44
of surgery too. Senator Peyton, thank you. If I could have everybody's attention, please read the bill, line 1314, 1516 and 17 that she's talking about the chair, says that you audiology does not include surgery using those instruments to in which human tissue is cut, burned, vaporize or removed. It's talking about you can't use
those instruments to cut, burn, vaporize, remove, or otherwise permanently altered by mechanical means, laser ionization, radiation, ultrasound, or other means. It's not saying you can't remove the bug. It's saying you can't remove any skin with it. Thank you. Thank you, Madam Chair. I would
disagree with removing tissue and human tissue, and I would disagree with the statements, but again, I see a conflict, but I'm just pointing
that out. Um, all right, anybody else have any questions, speaking for or against this bill, if not, you're recognized to close for the bill we're going to I'm sorry. We do have 3. We have 2 more. We have 3 more speaking on the bill. No, I'm sorry. 22 more. I'm sorry. I'm sorry, we have 2 more, Senator Penzo to speak. Um, for the bill. So before we recognize you for
closing, I'm so sorry. uh, Blair Casey. If you'll just state your name for the record. I, I appreciate. Go player
Blair Casey
Unverified
1:58:36
Casey. Madam Chair Irvine, Bo chair Wallace, and members of the
Senate Committee on Public Health welfare and labor. Thank you for the opportunity to speak today. My name is Blair Casey and I'm a 2nd year doctor of audiology student at the University of Arkansas for Medical Sciences. I would first like to state that these are opinions are my own and are not associated with UAMS in any way. I chose to pursue this path because I've always been driven by a desire to help people regain their connection to the world around them.
Auditory and vestibular. are essential for health, wellbeing, and quality of life, and I intend to dedicate my career to making a meaningful impact in these areas. Becoming a doctor of audiology is not easy. It requires a 4-year undergraduate degree and a four-year clinical doctorate degree, extensive clinical training and also a significant financial investment. My classmates and I are learning to
evaluate, diagnose, manage, and treat hearing. imbalance disorders using advanced technologies and evidence-based practices from conducting health screenings, diagnosing and managing tinnitus, hearing and vestibular conditions to performing non-radiographic imaging and removing foreign bodies from the ear our training is this comprehensive and challenging as that of other clinic clinical doctoring professions. We are
also trained and prepared to recognize when additional medical care is needed and to refer patients appropriately. SB 118 is incredibly important to me because it recognizes the education, training, and hard work, I and my classmates have invested to become clinical doctoring professionals. We chose this profession to help our patients, and we believe that audiology should be
recognized under the law in a manner that reflects our extensive education and training. This legislation will ensure that we can apply the skills that we have acquired in school to provide timely, effective, and affordable care to the people of Arkansas without unnecessary barriers. I do plan to stay in Arkansas after I graduate, but only if I'm able to practice to the top of my training. Anything less will be a disservice to me and my
patients. I urge you to support SB 118 and help future audio. just like me serve the community with the expertise we have worked so hard to gain. Thank you for your time and consideration. Thank you. Thank you
for being with us. Any questions? Great, see you then. Thank you so much and I appreciate it. OK. Dusty Richards.
Speaker 249
2:01:47
I'm Dusty Richards, audiologist in Springdale, Arkansas or Fayetteville. Um, thank you, Senator Penzo, for your support, addressing Doctor Manning. One comment you mentioned the compromise on we just speak.
I'm sorry, if you could just speak to the bill. Or
Speaker 249
2:02:06
I mean it does strongly here and wouldn't be able to because our bill is very similar. OK, um. The compromise was regarding
language, the scope of practice still passed. The scope expansion. Right, and medshy indicated support, thus I think you're colleagues were OK with the scope expansion. It was just the verbiage if I'm not misinterpreting that. Um, and I would agree to, and Arkansas is has a pretty nice record in terms of hearing aid coverage. You know, with the sales tax exemption, uh, we definitely like that, and more recently,
Arkansas vocational rehab coverage. Uh, you know, that cap has been Raised in years past, you had to be in the workforce, whereas now retirees who do want to be productive members of society, we can now And if you qualify for that, which is great, so I think it's OK that Maryland may be Um, you're one of the few states with press and Arkansas should be the leader that's been an ongoing trend. I would support
that. Um, and, and to be clear, audiologists, we don't have an interest in interpreting. Uh, blood cultures. Nor imaging any more than a chiropractor, correct me if I'm wrong, they can order X-rays, correct? For a radiologist to interpret. And so if we need a clear language on
Speaker 251
2:03:40
that, that's fine. And I suspect you're malpractice is better than mine. I wouldn't want to remove what you're talking about from here. Um optometry 2019.
Speaker 254
2:03:52
It was far more extensive. I'll you. OK.
Thank you. Thank you. All right, thank you. Are there any questions? Thank you for your testimony and traveling. to be with us. No questions. All right, see none. Uh, that's all
we have. Uh, you're reckon us clothes
Senator Clint Penzo
Unverified
2:04:11
for your bill? Thank you, Madam Chair. Um, I just want to kind of like the last bill, I said. This bill will help increase access to healthcare in Arkansas. Um, this majority of the members of this committee
voted in 2019 on optometry bill and the, the world was going to end. They were going to be blind people everywhere if you remember that, um, didn't happen. So, um, it's, it's the same type of thing. This is within their scope. We just want to expand scope to where they can, uh, uh, practice at the level they're trained to practice at. Um. this like Senator Hill mentioned, it also uh allows for patient convenience, um.
To have to send somebody for minor procedures to another. Practitioner, uh, if you can take care of it one stop, um, you know, I've, I've got a sister and I know it's difficult to get her to some of her appointments, um, just like it is an 89 year old adults, so, um, This is, this is important. It's good for our, our, uh, especially rural Arkansas, uh, increasing access to those people. Um Like I said, there's not a financial benefit to this. This is about serving the community
and expanding and allowing people to practice their full scope.
Um, I just would like to ask everybody for, for a good vote on this. I'm
closed. Thank you. Right, motion do pass, is there a second, 2nd, is there a discussion, Senator Love, so thank you, man.
Speaker 222
2:05:45
I think everybody was in support of this bill. I think that we were just trying to make sure that that
Senator Fredrick J. Love
Unverified
2:05:51
the clarification was there. I, I don't think he uh I think that you have anybody that's opposed
to it, but I do think that if you, if you pass it out as is without really checking to make sure that this language does not conflict with something else, then you're you're. You're probably in a worse position than you than you are when you came in with the bill and so I, I think everybody is in support of the bill, so don't get me wrong, it's just that you wanna just make sure that the language is is right so that you're not actually canceling out something. That's already under the practice of your scope. So that's, that's, I mean, I.
think this what it is, so thank you thank
Senator Clint Penzo
Unverified
2:06:37
you. Discussion Senator Penzo. Thank you, Madam Chair. Yeah, no, I'm, I'm confident that the language is the way it needs to be, and it's not going to impede their current scope of practice. I mean, uh, if you use a scalpel to put peanut butter
on your bread, it doesn't make it surgery. So, um, you know, it's, it's the way I read it and I've been, I, I've confirmed that it is accurate, so
um I'm, I'm not worried about messing anything up, but I, I do appreciate your. concern.
All right. Any other like discussion on the bill. All
right, see none. All those in favor say aye and opposed, I have it. Congratulations, you passed your bill. Thank you, and this is not amended, so it's just, OK. You didn't have an amendment for this one, correct? OK. Thank you. Members with that, we will see you upon adjournment. We're what? Yeah, leave your stuff here, Senator Ludding going to continue with scope bills
Speaker 104
2:07:31
or we move to non-scopes we're going
to go to, we're going to continue to scope bills this afternoon, Senator Homer. Senator Hammer. Wors are now.
Agenda
CALL TO ORDER
SB117 C. Penzo TO CREATE THE NATUROPATHIC PHYSICIAN PRACTICE ACT; TO PROVIDE FOR LICENSURE OF NATUROPATHIC PHYSICIANS IN ARKANSAS; AND TO CREATE THE ARKANSAS STATE BOARD OF NATUROPATHY.
SB118 C. Penzo TO AMEND THE DEFINITION OF "AUDIOLOGY" RELATING TO THE PRACTICE OF AUDIOLOGISTS.
REGULAR AGENDA
HB1255 Wooldridge TO AMEND THE COVERAGE OF A CONTINUOUS GLUCOSE MONITOR IN THE ARKANSAS MEDICAID PROGRAM.
SB222 B. Davis TO AMEND THE MEDICAID PROVIDER-LED ORGANIZED CARE ACT; TO CLARIFY MARKETING BY PROVIDERS UNDER THE MEDICAID PROVIDER-LED ORGANIZED CARE ACT; AND TO DECLARE AN EMERGENCY.
HB1245 Clowney TO CREATE THE ARKANSAS BEHAVIOR ANALYST REGISTRATION ACT.
HB1186 Vaught TO CREATE THE PAIN RELIEF PARITY ACT; AND TO REQUIRE PAIN RELIEF PARITY IN THE ARKANSAS MEDICAID PROGRAM.
HB1131 Pilkington TO AUTHORIZE AN ADVANCED PRACTICE REGISTERED NURSE TO DELEGATE CERTAIN TASKS TO MEDICAL ASSISTANTS AND OTHER UNLICENSED STAFF.
HB1166 Gramlich TO CLARIFY THE TYPES OF EPINEPHRINE FOR USE IN ELEMENTARY AND SECONDARY SCHOOLS IN THIS STATE.
HB1167 L. Johnson TO MODIFY THE SIGNATURE AUTHORITY FOR ADVANCED PRACTICE REGISTERED NURSES AND PHYSICIAN ASSISTANTS; AND TO CLARIFY THAT DURABLE MEDICAL EQUIPMENT INCLUDES DIABETIC SHOES AND SHOE INSERTS.
HB1254 L. Johnson TO AUTHORIZE A LICENSED PSYCHOLOGICAL PRACTITIONER TO PRACTICE INDEPENDENTLY IN THIS STATE; AND TO REMOVE THE INDEPENDENT PRACTICE PRIVILEGES FROM PSYCHOLOGICAL EXAMINERS.
HB1256 Wooldridge TO REQUIRE THE ARKANSAS BOARD OF EXAMINERS IN COUNSELING TO ISSUE A PROVISIONAL LICENSE FOR A LICENSED ASSOCIATE COUNSELOR AND A LICENSED ASSOCIATE MARRIAGE AND FAMILY THERAPIST.
HB1258 L. Johnson TO CREATE THE COMMUNITY HEALTH WORKER ACT; AND TO ESTABLISH A
Notice: Silence your cell phones. Keep your personal conversations to a minimum. Observe restrictions designating areas as 'Members and Staff Only'.
STATEWIDE CERTIFICATION FOR COMMUNITY HEALTH WORKERS.
HB1447 Long TO EXEMPT A SEPTIC SYSTEM INSTALLER LICENSED UNDER THE ARKANSAS SEWAGE DISPOSAL SYSTEMS ACT FROM LICENSURE AS A PLUMBER.
HB1478 Schulz TO REPEAL THE REGISTRATION OF DISEASE INTERVENTION SPECIALISTS.
SB264 Irvin TO ESTABLISH THE ARKANSAS PRIMARY CARE PAYMENT IMPROVEMENT WORKING GROUP.
SB265 Irvin TO REDUCE AND MODIFY THE MEMBERSHIP OF THE LICENSING COMMITTEE RELATING TO WASTEWATER AND THE LICENSING COMMITTEE RELATING TO SOLID WASTE; AND TO AMEND THE APPRENTICESHIP LICENSES IN SOLID WASTE LICENSING.
HB1213 Achor TO AMEND THE ARKANSAS ATHLETIC TRAINERS ACT; TO CLARIFY THE DEFINITION OF "ATHLETE"; AND TO DEFINE "HEALTHCARE PROVIDER" REGARDING STUDENT ATHLETE CONCUSSION EDUCATION.
HB1257 L. Johnson TO REMOVE THE LIMITATION OF THE PRACTICE OF NEUROPSYCHOLOGY FROM TECHNICIANS EMPLOYED BY PSYCHOLOGISTS; AND TO ALLOW PSYCHOLOGY TECHNICIANS TO BE EMPLOYED BY PSYCHOLOGISTS.
SB189 A. Clark TO AUTHORIZE IVERMECTIN FOR HUMAN USE TO BE SOLD WITHOUT A PRESCRIPTION OR CONSULTATION WITH A HEALTHCARE PROFESSIONAL.
SCOPE OF PRACTICE BILLS
Number Sponsor Subtitle
SB99 C. Penzo TO AUTHORIZE A PHYSICIAN ASSISTANT TO DELEGATE CERTAIN TASKS.
SB100 C. Penzo TO AUTHORIZE THE ARKANSAS MEDICAID PROGRAM TO RECOGNIZE A PHYSICIAN ASSISTANT AS A PRIMARY CARE PROVIDER.
SB101 C. Penzo TO ESTABLISH THE PHYSICIAN ASSISTANT LICENSURE COMPACT.
SB111 K. Hammer TO ESTABLISH THE DENTIST AND DENTAL HYGIENIST COMPACT.
SB119 C. Penzo TO ESTABLISH THE INTERSTATE MEDICAL LICENSURE COMPACT.
ADJOURNED
Documents
| Title | Type | Pages | Source |
|---|---|---|---|
| Agenda — PUBLIC HEALTH WELFARE AND LABOR COMMITTEE - SENATE AND HOUSE, Feb 26, 2025 | Agenda | 3 | Official source ↗ |
Speakers
Senator Missy Irvin Chair
Unverified
Speaker 11
Senator Clint Penzo
Unverified
Mamie Burris
Unverified
Speaker 29
Speaker 48
Senator Ricky Hill
Unverified
Speaker 70
Speaker 94
Speaker 97
Speaker 98
Speaker 99
Senator John Payton
Unverified
Speaker 114
Speaker 106
Speaker 130
Speaker 133
Speaker 134
Speaker 136
Summer Herod
Unverified
Senator Fredrick J. Love
Unverified
Speaker 169
Speaker 174
Speaker 189
Speaker 195
Speaker 57
Speaker 197
Speaker 198
Hope Gillison
Unverified
Speaker 203
Speaker 204
Lance Manning
Unverified
Speaker 211
Speaker 229
Speaker 245
Blair Casey
Unverified
Speaker 249
Speaker 251
Speaker 254
Speaker 222
Speaker 104