Public Health, Welfare and Labor Committee- House

real quick on the record what bills will be going back to the firm. And if any of you have any requests of your own bills during this time, please raise your hands and we'll get you back on deferred. Andrew Collins, Representative Andrew Collins, has asked that all his bills be moved back to the first, we'll be moving those. Next Tuesday Senate Bill 17 will be moved to the top of the agenda without objection. See none so moved. Are there any other requests for bills to move back to deferred. Representative Rose. Yes, I had. I had 2 Can you hit your mic? Yes sir, I believe I had 2 that were listed, um. 1456. I apologize, I can't find the second one at this time. I had sent an email to staff earlier this week, so if they could just reference that, um. I believe there's 2. OK, I'll get back. I'll get back to somebody on the 2nd 1. 1456, please. Thank you. Any others? Representative Bentley, House 1440. I'm doing a member's own amendment today, so I'll need it back for next week. You want it on active for next week? Yeah, active for next week, but I got an amendment today. Thank you. That one just stays active. All right, members, and if anyone has folks coming in for the meeting or needs to schedule a special order, please just reach out to myself or to staff member Ms. Shanise, um, and we'll make sure that we can accommodate best possible for uh you or your witnesses. So with that, I'm gonna take some bills out of order because of that purpose, um. So first off, uh, we'll run, we had a little quick bill here. We're gonna run Representative Steel's bill. Um, the House bill. 1428, and then we're gonna go to representative Jason Nazarenko for his bill. Thank you, Mr. Chair. Thank you committee. House Bill 1428 is a collaboration with the ADA industry recommendations and the Arkansas Hospitality Association. Which represents the hotel industries in Arkansas. While most regular rooms fall into 25 to 30 inch uh heights. Uh, this bill requires the bed heights to measure at least 21, but no more than 23 inches for the mobility accessible rooms. This allows for a smoother transit or transfer for disabled patrons. To the bed. This is already a requirement in hotels to have mobility accessible bathrooms, and that number is 4 bathrooms per 100 on the norm. This would allow those rooms with the mobility accessible bathroom to have the ADA required beds placed in the room as well. Hotels her grandfathered in. That currently are out there in operation and this requirement would be required for all new builds going forward. Those refurbished rooms are usually every 3 to 5 years. That requirement would be placed on them at that time in order to meet those requirements and recommendations by the ADA. So with that, I'll take any questions. See no questions or anyone from the audience speak for or against the bill? Representative, you closed for your bill? I'm close to my bill. Thank you, Mr. Chair. I have a motion from Representative Ferguson for DuP pass, uh, any discussion on motion? So you're not all those in favor. Say ah. I'll post. I have it. Congratulations bill passed. Thank you, Mr. Chair. Thank you committee members for your indulgence. Representative Nazarenko, you're recognized to present your bill, and my understanding is you have a handout, correct, thank you very much and uh that objection I'd can we get you on the mic first? Introduce yourself, your district number, and then you can make your request. Uh, thank you, Mr. Chair. Thank you, uh, uh, colleagues, uh, Jason Azarenko, representative for District 4, and I do have some handouts, uh, Mr. Chair, and then also, uh, respectfully request uh Patty Glenn, uh, to join me here at the table. She's the uh director of education and professional mobility with the Federation of State Massage Therapy and Boards. That's a proper request. All right, if you can just Introduce yourself as well. Thank you Chair and members of the committee, my name's Patty Glenn. I'm the director of education professional ability with the Federation of State Massage Therapy Boards and one of the experts on the interstate massage compact in here for your questions today. All right. Again, thank you, Mr. Chair and thank you committee members as they, uh, the handouts are being passed out right now. You're getting a couple different items there. You're getting a support letter uh from the DOD in support of Compacts. You're also gonna be getting a couple other support letters that's from the FSMTB, the Commission on massage therapy accreditation, massage magazine insurance plus massage magazine associated bodywork and massage professionals, National Center for Interstate Compacts. And the Council of State governments. I'll wait till everybody has those, uh, before I begin to. Alright, I believe everyone has those handouts now. Again, thank you very much for allowing me the opportunity to bring House Bill 1217 to you this morning. Uh, very excited about this, uh, this bill. Uh, this bill does exactly what it says it's gonna do. It's a uh a house bill for interstate massage compact and it's gonna be um it establishes the interstate massage compact, affording licensed massage therapists, the opportunity to join the compact once established, providing a pathway to practice massage therapy in Arkansas. And any other member state, allowing a great amount of flexibility and mobility, which is extremely advantageous in today's environment, reducing barriers to licensing and keeping Arkansas, uh, deployed or and employed, excuse me, not deployed. Uh, connecting myself to massage therapy, I think this is important, uh, about a year ago, I had a, uh, my sister who is a mass a master massage therapist and a successful business owner in our town and also obviously a constituent. She was experiencing some challenges employing a licensed massage therapist from other states, and she mentioned that to me. Uh, I was then connected with advocates from the Interstate massage compact, uh, because of my passion for veterans. So I myself retired from the army 5 years ago after 23 years of active duty, uh, service, and so I'm intimately familiar with um the stress of moving and trying to uh continue that job and uh when I found out that the Department of Defense had uh worked on this uh worked on this compact and uh supported it wholeheartedly, I became very interested and involved, uh. I found through the studies, as I, as I explored the study, I found that this impacts a whole lot more than military families here in Arkansas. Through the study, I found that uh it helped anyone from uh, from folks that are moving in here, folks that have lived here their entire lifetime, uh, as well as folks that need to be moving around in different states and operate. I want to talk about a couple uh statistics here. So currently there are 33 interstate compacts, uh, for Arkansas were members of. We have 8 occupational licensure compacts at this time. Arkansas is a member of 6 occupational compacts currently. That's audio speech pathology, counseling, RN, OT, PT, and psychology. 7 additional compacts are being considered in this general assembly. Uh, so as you can see, compacts are not a new thing. Uh, when we, uh, when established, they have the ability to make very positive impacts to the residents of Arkansas and our member states. There are 22 states that have established this interstate massage compact. That's Nevada and Ohio. There are currently 9 states that have legislature ongoing at this time. That's Arkansas, Alabama, Georgia, Montana, Maine, New York, Connecticut, Virginia, and Illinois. Some of the questions that I raised and that you are probably thinking about right now in regards to the interstate massage compact focused on requirements of the Arkansas residents and the cost to the licensees. As well as cost to the state and the ability for the Arkansas for Arkansas to remain sovereign through this entire process. So in regards to any requirement for an Arkansas resident massage therapist, it is completely optional for anyone to join the Interstate massage compact and in no way affects an Arkansas resident and licensed massage therapist who chooses to only practice massage therapy within the state. The cost of the interstate massage compact is currently estimated at 1.5 times that of the current license for Arkansas, which is roughly $80. As I mentioned, this is estimated because the cost will be established once the Compacts commission is established, and the rules are promulgated. The 1st 7 states that joined the compact will create the commission, which is another great reason for us to get involved now. If we are one of the 1st 7 states, we will have a seat at the table and a vote towards the rulemaking process. Which would be a first for a first for the, uh, for compacts in Arkansas that we've joined. The cost to the state. I did request and receive and you should have a copy of the fiscal impact statement. It shows an estimated $15,000 initial requirement and $6000 annual requirement. I reached out to Arkansas Department of Health in regard to both of these estimates, and I, as I, as I tried to mirror them up with a compact and was unable to do so. Speaking with ADH, I was told that this was purely a guess and costs were more than likely going to be much less than this. But the Arkansas Department of Health had to estimate something and they wanted to err on the side of caution, uh, comparing this to other compacts that have been previously established. Uh, as, as far as Arkansas's sovereignty, You can see clearly in the proposed bill language that nothing in this compact shall be construed to be a waiver of sovereign immunity by the member states, by the commission, and then all laws of the member states governing malpractice and misconduct are not not hindered. You can see that on page 2, 26 and uh line 26 and 27. You'll see it again in page 17 lines 10 through 19, and it can be found in a couple of different places throughout the uh compact. I reached out to Arkansas state police, human trafficking division in regards to this bill, especially, and we discussed how the compact uses the nationally red and currently accepted massage and body work licensing examination, or MLEX for licensing massage therapists here in Arkansas. The Interstate massage compact also creates a national registry of licensed massage therapists that have met the requirements to join the compact and are in good standing. Which were both discussed as being excellent ways to make it harder for the bad actors, uh, to enter and set up shop here in Arkansas and how maintaining a strong, proactive approach would help ensure safety for all Arkansans. Arkansas's current pass rate for the EL is 80%. With a national average of 70%, which indicates maintaining this standard is a good choice. The Arkansas State Police maintains a neutral position on this bill and was available for educational purposes through the discussion. I believe it's also important to note that at the early stages and development of the ELEX, Arkansas was one of the key contributors for this exam and continues to be one of the recognized industry leaders and developers staying in the forefront of the industry using the exam for licensing. The Department of Health maintains a neutral position with no concerns noted when I I discussed the compact with them. The Attorney General's office also maintained a neutral position with no concerns noted when we talked about the bill. The uh American massage Therapy Association AMTA is in neutral position towards the compact and the Federation of State Massage Therapy Boards is in favor of the compact and is ready to assist in any way. Local businesses and licensed massage therapists overwhelmingly shared that they were in favor of the compact and, and the added pathway that this would provide. I personally think that a good an example of uh this compact in action is a good way for you to see how it's a good choice for Arkansans. Last year in my district, we had a tornado and it was shortly followed by a flood, uh, if we would have had a massage establishment that had been destroyed in that, and either one of those disasters, every one of the licensed massage therapists that had worked, that were working in there would have been displaced and without a paycheck. If the compact was in place at that time, those uh those licensed massage therapists would have the option to Go and work at a member state immediately having a paycheck and being able to maintain that, that, uh, that positive uh flow for their family. Um, another good example is, um, someone who has a Um, a licensed massage therapist, uh, licensed massage therapist that tragically ends up in, in a situation of domestic violence. Having the uh compact in place allows them the opportunity to go to a member state when they have to avoid being around in this area for a certain period of time, uh, allowing them immediately have a paycheck that, uh, that's gonna help them mentally and physically as well as their, their family having that income and no, no negative effect on that as well. So as you can see by these examples, there are many positive aspects for establishing the interstate massage compact here in Arkansas. This is a good bill that will make positive impacts in the lives and families of Arkansans with veterans, veteran spouses, and civilians alike, allowing them to maintain a constant income and a pathway to a productive future for them and their family while filling the needs of the community they serve, all while ensuring we do everything we can to keep the bad actors out of our great state and ensuring our massage therapists. Continue to stay in the forefront and relevant and not left behind or being reactive in nature to the advancements in this industry. With that, I'm open for any questions. represent a Ben Lee you recognize. Thank you, Chair. Thank you, uh, Representative Nazarenko, for bringing this couple of questions, um, emails that we've received just at the, um, hours are longer for the joining the compact. So is that true that what currently is a 500, 500 hours of do and if we join the compact, we'll jump up to 650. Is that accurate? I'm just wanting some clarity on that. So I'll answer that in part and then I'm going to pass over to Miss Patty Glenn because she's gonna be the expert, but, uh, 625 is the, the number, not, not 650, but uh, Miss Patty Glenn be able to, uh, speak on that. So you'll notice in the legislation that there's 2 sections to this bill. The first section delineates the requirements for the state to join the compact and the state's requirements to join the compact are met in full by the state of Arkansas at this time. They just simply have to have an educational requirement in order to be able to meet it. The individual therapist, in order to ensure as the technical assistance group put this compact together under the oversight of the National Center for Interstate Compacts at CSG determined that going with the entry level analysis project that was done. about 11 years ago in the massage profession over a several year study by the major organizations which had set that at 625 would help us address the issue of inconsistencies and regulation ensure that therapists moving across state lines met or exceeded the requirements in each of the states they might be working in. So you'll see that subsequent section are specific to the therapists themselves that join the compact. I know there's some people here today they're going to be testifying on what the specific requirements are in Arkansas, but what we know to be true and you'll see in a joint letter posted both on FSMTB and AMTA's website is that as the commission puts the rules together, the 625 hours will be able to be met both by core education taken through their, you know, education to licensure their primary schools here in Arkansas, but also incorporating continuing education taken as well in order to meet that requirement of 625 hours for the individual. therapist. Thank you, uh, Representative Bentley for that question because was one of the things that I looked at as well, uh, because that that was brought up to me and what I loved about this is being able to be on the forefront of it, where we have the option to be able to actually sit at the table and when they start promulgating those rules, we have a say in it and, and I think that's really great and it's, it's a, uh, it's a testament to how Arkansas has been able to stay in the forefront of this industry, which we wouldn't even, you know, have known, so thank you very much for that question. follow up, chair, that's OK. So, um, We all want to have a military families. That's why we've done the other things to make sure that the spouses that move here immediately get their license on different things. So remind me what the two states that are um currently in Nevada and Ohio are are in currently and then there's other states that are in legislation right now. OK. All right, that's all I have for them right now. Thank you, Jo. I guess one of my concerns is on page 15, lines 29 to 36. And you alluded to this with your cost estimate a while ago, but there's no way to know what that cost is going to be. And if you follow along, it says you can levy whatever fee you need to cover the cost of that. Uh, of the compact. Can you lead us into some examples of what that may look like. Thank you, Mr. Chairman, and again, I'll, uh, I'll Go with the, I'll, I'll head over to Patty for this answer. Uh, I did have that highlighted because I know that uh we had talked about that before as well, um, Miss Patty, have you got? Thank you. You bet. So historically, actually, I think there's only one other compact that has assessed or has an assessment back to the state for participation in the compact itself, and that is a a bulk or a fixed amount, and it's my understanding that commissions actually looking at removing that requirement. So with massage therapy, it might be a little bit. different. So like we said, we anticipate that the states would be about a year or 1.5 times somewhere in that less than 2 times their annual license amount. Otherwise, it doesn't make fiscal response, you know, fiscal is it 1.5 or is it 2 times? That will be a determination. It could be a state determination. So the commission will have a set fee and in massage therapy, we have states that have fairly robust departments. We have other states that may have departments that are lacking staffing right now. So the anticipation of the commission comes together is to take a look at that. Landscape and determine how much administrative support the commission itself might need to provide in order for states to participate. I think, I think my problem is bill leaves it so open that you can send a bill for whatever you want. I'm fairly certain that that boilerplate language is consistent in all the other compacts, but unfortunately CSG wasn't able to be here to speak directly to that today, but if we look back at the other uh compact legislation that's been enacted in the state that this portion of the bill is that boilerplate compact language for. professional licensing compact so, Chairman, the only thing I could do, I guess, to give you any assurance on this would be to say that we intend to follow the same processes and procedures that other compacts and commissions have followed, and there is a good precedent set by these other commissions to keep these fees reasonable and cost-effective. When the Federation was established as an entity that is governed by the massage regulatory communities across the state or across the country. The intention, uh, in our, uh, mission statement and in our following directives was to help make uh licensure. more seamless and efficient and effective process and to remove those barriers for your licensees. This is part of the original mission of FSMTB when they came to be when Arkansas was a founding member of, uh, almost 20 years ago, and this is the fulfillment of that mission to help us get to that point where we can fulfill the needs of the therapist and of your constituents here in Arkansas. The intention is not to create any additional fees or levy any hardship on the state. In addition, one of the fees that exists in other compacts is. An assessment to help stand up the database itself again as part of FSMTB's commitment to the profession, the massage licensing database has already been developed. There will just need to be that additional module for the multi-state component, so we don't anticipate any assessment whatsoever. It'll be covered in the costs that are that exist in FSMGV back to the states for any part of that database. So again, expecting that this will be a much more streamlined and efficient process then that maybe we've had in in the past. Well, if you follow me over to page 19, what you just said is, is been my main problem with Compas all along. Go to line 11 through 23, it goes through the rulemaking process. It basically gates, the current rulemaking process that legislature has oversight over by giving that completely to the commission. And when you look at the public notice, the only public notice you're going to give is on your personal website. So if a member of the massage therapy community is not physically watching your website, they're not going to know about a proposed rule change. Nor are they going to have a way of fighting that proposed rule change. And if you follow down, it says that we can, we can adopt a resolution or change the law up to 4 years after you do that. I mean, that seems like A crazy way to look at rulemaking when they, if they do it here in the state, you could fight it that day. So again, I would have to go back to precedent, sir, um, FSMTB sends its inception 20 years ago has always been inclusive of the profession, the regulatory community, again, the regulatory community are our governing members. So while that's the mandate that it must be placed on that website, uh, I can assure you that practices through the entire technical assistance process and the development of this language itself or to be as inclusive as possible to push it out to all the members, to push it out to schools, and to push it out to the profession, which is why you'll see in those letter of support from all of the major organizations that they feel like they could also trust this process and for us to do due diligence. And again, I guess reaffirming too that the only rules promulgating uh opportunity that this commission has is those that are afforded to it through this statutory language. We don't have any oversight or any intention of promulgating that affect a lot of trust is what I see any questions from the members? Representative Bentley, Chairman, could we have Matt Gilmore come up here from the Department of Health. I really have a couple questions. Mr. Gilmore, can you join us at the table? Me. Go ahead. You want to introduce yourself for a record. Matt Gilmore, Department of Health. I got uh one of our attorneys here, Craig Smith as well. Thank you for being here with us today. So my quick question is, um, and all of us are very want to take care of our military and our veterans. We'll make sure that families that move here can quickly get a license. Tell me real quick, what's the process if somebody moves here with their spouse and has a massage therapy license. What did they have to go through? What's the time frame? Can you tell me that right now? I may rely on Craig for some of that, but we have automatic licensure for military folks, um, that are moving here, um, it's, I mean, if they've got, if they fill out the application and go through the background check. I mean, we're talking a matter of days at the most, I would think. Yes, we try to act like that as quickly as possible, um, but it is automatic. It is not, it is as simple as we can make it. I thought that's what it was. Thank you for clarifying that. So my other question is I guess, um, what do you see the ramifications? What do we have to set up an apart apartment there? What is the Department of Health going to do if we pass this compact? We're just going to be, what are we going to put a your feet to have to do. From what I've seen with other entities that have compacts under us, um, you know, some of them are similar to this. They're still in the uh Forming um, you know, their rules and their and their membership and their processes, um, typically, uh, it, it is a little bit more work on the staff, but I mean it's, it's, it's minimal. I mean there is some travel, but it shouldn't typically they don't require, you know, any additional staff per se, um. It's just mainly getting through the process working with the the national compact, um, you know, uh, Some of the members of the of the different boards and commissions are on those compacts, so there's a little bit of travel for them. Um, it's usually not too difficult. I mean, working with that database, you know, depending on what that requirements are like and what our systems are like, there may be some, you know, challenges or, you know, issues there, but, um, Each one's a little different as far as each each board is in commission is a little bit different as well, so it just kind of depends, but um, I don't know if I'm answering your question or not, but it's, it's, it just depends. I guess I'm trying to clarify on the uh fiscal impact, where is the, what, what do you have to spend money on, I guess that's what I'm asking you. As far a day to day operations, I may let Craig jump in on this, um. There will be some check in the database. There will be some additional steps here and there. I think the, the cost as y'all discussed in here, there will be some kind of annual fee usually now, you know, from what I just heard, they, they may or may not, I don't know how that'll work out with the commission will have to decide some of that once I get formed. Um, there will be some cost to the licensees, but they, they usually pay that. Some of the, some of the boards that I have, um, they passed the annual and initial fee onto the compact members that in the state that want to be a member, um, sometimes we have to eat that initial uh cost just to, you know, because there's no, we got to get it set up and moving, but the annual fees, we try to sometimes um morph those into the uh the applica or the uh renewals if they're a member of the compact, and then um There's also additional fees for each person that joins the compact, and those can vary. So, um, but as far as set up, I mean there will be some technology, um, cost or issues there, but we can work through that. So it's, they're each a little different and this one's, I think getting formed from what I from what I was told, so I think we're maybe a few years out. I don't, I don't know, so some of that may change or it may have to just, you know, adapt as we go forward. Thank you. Thank you, Chairman, for the questions. I appreciate that's all I have. Representative. Thank you, Mr. Chairman. Mr. Gilmore, my questions for you and, and potentially uh Representative Nazarenko, but I think that part of the concern that I have or, or heartburn that I have with this is, you know, we've all seen in the news, they're good actors and they're bad actors in every profession. This profession is, is not exempt from that. When we allow folks to practice across state lines, kind of ebb and flow in and out of the state. Where does the oversight fall for this? How, how are we going to monitor those good actors. versus the bad actors. And, and when I look at page 2, section B, line 90 no, I'm sorry, line 11. It talks about uh the member states' ability to prevent human trafficking, uh, and licener fraud. So I mean that, that's gonna fall back to the state to have the burden to prevent all of that. The compact doesn't help to prevent those type of things. I don't understand, I guess, what is the benefit of the compact? It seems to me that we're opening the state up for more potential opportunity for these things that we're going to have to regulate and monitor at a higher level. Could I get your feedback or opinion on that? I'll start and I'm gonna let Craig jump in. He works closely, um, with our program. You know, as far as going state to state, I think the compacts do help, um, there some, um, you know, you see it some with telemedicine, which I'm not sure that would work with massage real well, just to be honest with you. Um, but I do, you know, They're going to have to have a background check, um. And I think the national uh requirements, I think require that, if I remember correctly, when I looked through it. So there will be that uh check, you know, some, some compacts require um the members to notify the state when they come into the state. I'm not sure that happens all the time, you know, but and there's not, I don't know if there's a way to to police that, um, you know, it's, It's gonna, it's just, it's gonna vary, you know, I, um, There's pros and cons. I mean, it's just, I think again, I've seen it work well with telemedicine and border border areas of states, but, uh, massage is gonna be a little bit different because of the nature of the practice and Craig, do you have anything you want to add as far as the background and the human traffic and that sort of thing. Yes, sir, representative, um. The, uh, to your point about um massage therapists coming into the state. If there are ones that are coming in the state to live here, work here, there are, uh, other ways that can do this. This will make it easier on some of that and for those that are here, we can regulate as we have been and do our best to continue watching for those that are um Practicing in bad faith. But those that come in to work for a little bit and go back, this will set up a process for work with those other member states on working with them for any enforcement, any disciplinary, any, any issues that come up and so it will be require some relationships with those other states. So then I think that's the point that I'm trying to make. Do you, do you all have the current manpower to be monitoring this across all states if this compact becomes extremely large. I think we'll have to just kind of gauge as we go, uh, you know, it's gonna be incumbent on the, on Arkansas if, if y'all do this and the states that join to make sure they follow the process and notify the if there's any issues the national group and then, you know, and for us to do our part as well and notify if we see issues and, and just hold people accountable, um, you know, it's every, every profession is a little bit different. This one's seen some challenges recently, um, with, um, uh, just different, uh, as y'all see in the news some. That's why I think you're seeing some different legislation. I think this session, but um it's, it's gonna be incumbent on the states to, to follow the rules and to monitor it closely and, I mean, we, I'm not, I don't want to ask for staff. I don't think we need staff right now, but you know, we'll have to just monitor as we go forward and see, but there's always, you know, enforcement, the delicate situation. You don't want to be too hard, but you also want to make sure people follow the rules and protect the public. Absolutely, and I think to your point, you know, I'm not trying to paint the profession with a broad brush. I think they're are bad actors. across the board in in any profession that we have in the state of Arkansas, but I think that we do need to think about what this is going to be in terms of as we move forward, I know when we start to build this up, there's a lot of potential for growth and burden to the state that that I think based on uh the line that I pointed out, that's solely gonna fall on the state to do that and monitor that so we just need to be mindful. Thank you, Mr. Chair. Any other questions for committee members? Representative Pilkington, you recognize. Mine's not for the health department, it's for the representative Nazarenko. OK. Hey, Representative, uh, so my question is, we OK. Um, You know, we have passed compacts in the past, uh, you know, I, I remember two last session I had one and Representative Delia Hawks had one, but one of the things that we included was language that allowed ALC to review any rule changes that had happened. It was kind of a safeguard to make sure that if anything happened, we would be able to stay to to do things there any sort of language because I didn't see this spill, but I know we've talked about in the past and, and, and I can't remember that conversation, but you got to talk about that to make, you know, do we have anything like that in this? to kind of help protect us because we put that on the other compacts and that seemed to assuage some of the concerns members had last session, and I'd be curious if there's anything like that in this one, and would you be amenable to adding that to it if, if that would maybe make some people feel more comfortable about it. Thank you, Representative Pilkington. And if with uh without objection, I'd bring uh Miss Patty up to to address that. Any objection? Can I object? I'm just kidding. Again, not the council of state governments, uh, Center for Interstate Compacts experts, unfortunately, but it is my understanding, sir, that the um compact language needs to remain substantially, you know, equivalent across all states and so, um, council state governments would be better to speak directly to that and why that language does not exist, but again, specific to, you know, only the ability to promulgate rules within and set law within the confines that are established by this very specific legislation, so. I know that was a non-answer answer and I apologize. That, that's fine. I just, I, we had a previous conversation. I just, I thought it was good for the committee to, to hear that. Thank you, and I did speak with Ms. Delia yesterday and kind of we spoke in depth about her bill and this bill as well and you know, this one I keep going back to that if we get a seat at the table then as, as that, you know, commission is formed, we get to, you know, have a vote and and that to me is very important because then as these things come up, that can be added in and said, hey, you know, we want this, you know. We actually have a, a voice where we don't have a voice right now and and others, so thank you. Any, any other questions? See on anyone in the audience. Uh, we do have some folks signed up. We have a Julie Ernest speak against the bill. Yeah Yeah, that's it. Everett, I'm sorry. OK If you would introduce yourself for the record, and you'll recognize to be against the bill. I'm Julie Eckert. Um, I I appreciate you guys, uh, hearing, hearing me today on this. Yeah, turn your mic on. I'm Julie Eckert. Good morning. Um, just a little background, I'm retired law enforcement with 25 years from the North Little Rock Police Department, uh, specialized in human trafficking for 20 years, 20 years in sexual assault, uh, as a sexual assault detective was also assigned to the FBI, human trafficking task force during my years there. So, um, My retirement career is massage therapy. I actually go to the women's shelters and help with uh. Trauma massage there. The, um, one of the main issues coming from law enforcement background. Is that every single state in the nation that legislates massage therapy. has completely different massage therapy laws, and that has been completely disregarded by this impact. In Nevada, one of these um places. I have them here, so Ohio's. This is Nevada's. It's 72 pages. Um, and here are the other ones that are, that are pending. Some of them are. are 4 pages long. New York is 4 pages long. Um, Arkansas actually has a a pretty good uh pretty good set of rules in place right now, although I feel like they could be strengthened for human trafficking, but in Nevada, if you fail to pay child support, you can be denied your massage therapy license, but we wouldn't have to know that. Even though we could go practice in Nevada because that's not part of the impact, um, There's uh different licensures in Nevada that we don't have in Arkansas. There's a license to practice reflexology and a different license to practice structural integration. Uh, there's also grounds for refusal to issue a license, convicted of any crime involving violence in Nevada. Um, however, as a former MTA committee member, um, they have actually put through people that have committed homicide. To be a massage therapist. In Arkansas. Which that also needs to be changed in the language that we have now. Um, in Ohio, which is the other state that's currently in the impact, uh, they actually are allowed to take the pulse, temperature, and blood pressure of what they call a patient. They don't call them clients. They call them patients because actually in Ohio, uh falls under the department of nursing. They may also apply ultrasound and uh diathermy, I'm not sure I'm saying that right, electrical neuromuscular stimulation and or substantially similar modalities that the patient has been directly referred to in writing by a physician. We don't do that in Arkansas, so that means people coming from Ohio wouldn't know that here either, because at this point in time, they're not right, they're not required to take the Arkansas massage therapy law exam when you come into Arkansas. In fact, anyone that moves here is not required to take that test at this point and I feel like that should be something coming up in the legislature that should be changed. If a person wants to come to Arkansas from out of state, they should know what the massage therapy rules are for Arkansas, and right now there's only 2 other states that you would have to be familiar with their laws in, but with the nine other states, I'm just not real sure how everyone's going to be able to be familiar or even required to be familiar with those laws at all. Um, Representative Bentley asked about reciprocity and was answered with that it is automatic for military, for anyone that's moving out of state. Uh, also, if, if you're not military, All they have to do is have the transcript of Of the school that they that they attended and it needs to meet the 500 hour that's required in Arkansas. Um And that, that's what you need to have. You need to be in good standing with your massage therapy license. The impact requires everyone to have taken the, uh national exam, which is administered through the FSMBT. To be a part of the impact. So you have to have taken that test. So if you became a massage therapist before 2007, You can't join. Because that test didn't even exist yet. So that was one of the reasons that the uh ATMA. had posted That, uh, that the impact as it's written right now creates barriers and restrictions and could impose unnecessary hurdles and exclude many licensed therapists from being able to participate. It ups the hours to 500, uh 625 hours, which can be earned by CEs by continuing ed, but 5 other states have already gotten rid of the requirements for continuing ed and their 500 states. So they're not ever going to be able to meet that. And 21 other states in the nation are set at 500, along with Arkansas. The other thing that was brought up was human trafficking. In a 15 minute search. Uh, these states. That uh I'll take the national exam. There's Michigan, uh, Pennsylvania, Louisiana. In Ohio Um These are, this is just a 15 minute search of all the human trafficking busts. In these states and we all know about Arkansas. So somewhere, Something is slipping through the cracks because some of these people do have license that are trafficking these women and for us in Arkansas, we need to be making the The Massage therapy laws, we need to strengthen them. To be able to combat human trafficking in our state and for people that think that they want to come to Arkansas to be able to look at the massage therapy laws in Arkansas and decided that they would be better off to go to Kansas, where massage therapy isn't even regulated. I, I feel like this opens up the door because clearly they're not doing a good job right now in regulating people with licenses on this human trafficking business. And I feel like the state of Arkansas and the Attorney General and all the work that they have put into this lately, that they're doing a great job of, of trying to clean up Arkansas and opening up our borders to people from Nevada and Ohio. I don't feel it's a good idea. Thank you. Any questions? Any questions from committee. See you. Thank you for your testimony. With that lady of the Ashley Smith, uh, speak for the bill. Good morning everybody. Don't need it. Good morning everybody. My name is Ashley Smith. I'm a master massage therapist and small business owner based in Little Rock, Arkansas. I fully support this bill because it will streamline license portability for massage therapists, allowing qualified professionals to work in participating states without navigating the costly and time consuming licensing process. This compact offers several benefits from massage therapists, it provides the freedom to practice in multiple states, which can increase earning potential and reduce barriers to to career. Growth and relocation from military spouses it ensures they can continue in their profession when moving to a new state, providing stability and job opportunities despite relocations. For spa owners and businesses. It gives access to a broader pool of qualified professionals, helping to address staffing shortages and improved client service. This will bring more massage therapists to Arkansas, eliminating white toms and ensuring a quicker start for professionals to begin their work. Additionally, the compact brings protection through mandatory background checks for every massage therapist ensuring safety and trust within the profession. Thank you for considering this important legislation to support the growth and mobility of our industry. If anybody has any questions, I would like for Miss Patty to answer for me. She's got all the answers. No offense, but the rules of testimony are you testify, you have to answer your own questions. Uh, any questions for the witness? So you're not members we are bumping up against the timeline. So I'm asked to sponsor the bill, um. What his feelings are, there are 3 other people signed up to speak for the bill, um. If you want those to speak, you can. If we hit 11 o'clock, we are going to adjourn and we will not reconvene until Tuesday morning. So that is your Prerogative. Thank you, Mr. Chair. Can I bring uh Ms. Patty Glenn up. She can, uh, testify less than 3 minutes and then I can close and I believe we can get out of here before 11. Thank you. Thank you very much, Ash. I feel like the committee's probably heard enough from me today, but I appreciate your time and the opportunity to be here. I'm just gonna go through the testimony that I had written as quickly as I can. Um, we've already talked about FSMTB being a nonprofit and Arkansas being one of the original founders and that it is governed by the regulatory community, so no need to review that. Um, I wanted to talk about a couple of things that were just brought up. This in fact does not weaken regulation. In fact, it strengthens it. uh, therapists must have passed the massage and body work licensing exam, as you heard, which is the regulatory exam recognized and accepted by 46 licensing jurisdictions in the country. In addition to that, it requires participation in the secure national database. That database allows communication between the states on all licensed therapists that are in the system, in addition to the multi-state license holders. Again, multi-state license holding is a voluntary option and just another pathway. So for example, if a therapist only wanted to practice here and in Missouri, they can still go the traditional path of holding licenses in two states, but holding that multi-state license allows them to not have to jump through all of the regular. hoops in each of the states and have to pay the requisite fees and meet those individual requirements. I also want to talk just really briefly on the issue of differences in scope of practice, as you heard in testimony, the scope of practice does vary, as we stated earlier, it varies, and that's why the standards were heavily worked on by the technical assistance group to ensure that as many people could participate as possible. However, and as you heard, some individuals may not be included. I've been a therapist for almost 30 years. So, I currently live and reside in Kansas without having regulation. Kansas cannot participate in the compact, and Therefore, I'm not eligible for a multi-state license. That doesn't preclude me from traditional pathways. So I would like to advocate on the fact that this does help therapists to move, and if we don't adopt the interstate massage compact, then we restrict our therapists from having that portability and reciprocity. The other piece I want to touch on really quickly are two things very, very quickly. One, differences in scope of practices like differences in driving laws. I hold the driver's license in one state, but I can drive in every state in this country, and if I violate a law there because it's different than the law in my state. I'm still accountable to that state for that violation, and accountable to my home state if it's egregious enough, but my home state might also take action on my license. Multi-state licenses are a privilege that are valued and treasured by those individuals who work to obtain them, and as such, they are not your lawbreakers, they're your law abiders. On the human trafficking element, I wish I could say that it's predominantly unlicensed practitioners, and it is, but we are seeing a growing attempt by those bad actors to infiltrate the licensing systems. This again with the national database helps to prevent bad actors from just failing to tell Arkansas that they had their license revoked in Arizona, because they don't even have to disclose to you. They've even held that license and currently there's no way for you to know that. With that licensing database you would have that information and be able to see discipline taken in. any other state before issuing home state licenses here or taking action on a potential multi-state license holder that might have violated the law. Thank you for your time today and I'm available for questions. Any questions for committee? See you, you recognize the clothes for your bill. Thank you, Mr. Chairman. I didn't know if you needed to have discussion prior to me closing or anything. OK, I am prepared to close my bill. Uh, thank you, Mr. Chairman and colleagues. I really appreciate you affording me the chance to bring this great bill, uh, to you today. You've heard of the positive impacts that the interstate massage compact can have and the additional pathways that this can provide for Arkansans uh that have a desire to remain mobile for a number of reasons while meeting the needs of the communities that they serve. We had the opportunity to help the practitioners in this industry preserve constant employment while maintaining relevancy and top quality care. This can be all done while we as legislators do everything we can to ensure we keep the bad actors out and the good actors engaged, whose main desire is to serve their communities, providing their expertise to those in need. I thank you very much, and I asked for a good vote. What's a pleasure to the committee. Motion have a motion to pass in discussion on a motion. Members, I would say that I agree with Representative Pilkington's request earlier, last session. Myself personally asked for those amendments on those bills to ensure that the state of Arkansas had a say in those rulemaking authority and both times those amendments were added and anytime those rules change, that will come to ALC so that you can go back and face your constituents and know that those rules were done in good faith to that profession. And I think in good faith that this bill doesn't have that, you're giving up that authority. I mean my last term, so you guys have to look at your constituents over a number of years and be able to face them to say that you gave up that authority to some national company to set rules for their profession. So with that, I'll be voting no until that amendment is applied. Any other discussion? Representative Rose parliamentary inquiry, um. At this point of discussion. Is the bill sponsor allowed to comment? No. OK. He's not on the committee. Um. I could be open to withdrawing my motion if the bill's sponsor was willing to make that amendment, but I won't withdraw that at this time. That's, I would take a head nod from him if he's willing, and I would allow it. Uh, nodding head. Would you, would you like to withdraw your withdraw my motion, Mr. Chair. Thank you, Representative Nazareto. Your bill has been pulled back. Thank you, Mr. Chairman. you recognize to concur in Senate amendment. Thank you. If it's OK, I'm going to, we had one more moment to my PCT bill that just for the nursing board to clarify some language for their registry. So, um, it's just my bill, my amendment. I appreciate a good vote. That's proper explanation. I take that as a motion to concur. We have a motion to occur on the floor in discussion on the motion. All those in favor, say ah. I pose, I have it. Thank you guys. That's all we have today.