Public Health, Welfare and Labor Committee - Senate

All right, members, I'm going to go ahead and call the public health committee meeting to order. Um, today on your agenda, uh we have the special order of business, um, these are the bills that we'll be hearing today. HB 1183139, uh, SD 139, HP 1427 SB 99 SB 101 and HB 1181, and, um, the rest of the bills, um, are on deferred for today. um, until those sponsors can get with me and uh we'll get those scheduled for the next future agendas. All right, with that we're going to go ahead and move to HB 1183, Representative Bentley, you're recognized. You'll just take your name for the record. You can, you're recognized to present House Bill 1183. Thank you, Chairman. Thank you, colleagues. They will bring House Bill 1183, a very simple bill to help our certified dialysis, uh, patients across the state. So, this bill does two things. Uh, the first thing that allows our PCTs to give heparin to the patients there as they do in 38 other states, and that sets up a registry with the board of nursing to keep up with those folks that are patient care techs so they can, if there's a bad act or whatever, they can keep up with it. So it sets up a registry in the nursing. forward and allows these patient care techs that have been trained and certified nationally to be able to give heparin like they do in 3838 other states. So currently right now, as it is, we have a ratio of in most clinics of 12 patients to 1 RN and 4 patients to 1 patient care tech so I don't know guys have ever been to a dialysis unit to watch these folks in action, but they're very highly trained, they'll set the candle in there and um as most of you know, if you don't have heparin in that dialysis. machine, it's like not having oil in your engine it's going to stop that. There's no way it's going to run. So right now, the patients have got to stop, get a hold of an RN to get over there and push the heparin in order to keep the machine going the way it needs to. So this will allow them to work together. They'll set up parameters that are already in um in their instructions on what they're to give, how much heparin to keep their blood pressure where it needs to be, so it's all very well regulated and controlled the RN is always going to be present to ask any questions, but again, this will allow patients to get better care. I think, uh, I was actually at a meeting the other day and had an Um A sweet woman come up to me and say, thank you so much for this bill. Now I'd have to sit around and wait on that RN to find time to get over and press my hip and I'll be able to get out a lot sooner. She was really happy, so it's not often that we get to pass a bill that actually helps patients and helps people in their everyday life. I'm really glad to hear that. So it really is a good, a very simple bill allows them to give heparin as they do in 38 other states and like protocols already set up safety protocol for that and allow them to and allow the nursing board to set up a registry. We have done, um, A bunch of amendments. Senator Penzer did another one here to bring it here today for the nursing board to get the registry set up the way that they wanted to. The uh medical society want us to put a car right in there for those physicians that are doing, have already doing this in their own office. They didn't want to be a part of this, so it allows them to do what they're already doing in their own private practice. It just, again, uh allows those patient care techs to be able to give heparin at the direction of the RN and to keep their patient flow moving quickly in their units. So with that, I'm happy to take any questions that any member may have on that. All right, are there questions from members of the committee? See none? And there's nobody to Speak for or against the bill, um, what is the pleasure or you, you're recognized a clothes for the bill? I'm close. Thank you. Motion to pass 2nd, all those in favor say aye and opposed, I have it. Congratulations. House Bill 1183 is passed. Thank you there as representative Bentley, House Bill 1181. 0, thank you. OK, so, um, 2 years ago, I passed a a House bill to allow uh certified nurse midwives to have a full scope of practice, and we know how much we need uh skilled medical people in the healthcare facilities, especially when it's to come and deliver our babies. I assumed when I passed that bill that discharge and admitting privileges would be part of that, but it was not. So this simply adds to the um the bill that we already passed. It allows for discharging admitting privileges for certified nurse midwives and for them to allow to, to fill out the death certificate if that should happen, unfortunately. So I'll, I'll give you guys a minute to pull it up, Senator, uh, one's being nice to me, let me get both bills around while I'm here. House Bill 1181, so, and there's been, I actually no no opposition to the bill work with have not heard from anyone in opposition to the bill. And this is permissive, correct? This this is permissive, the hospital's OK if they have, yeah, it's up to the hospital to give them permitting to allow them to have that privilege. Yes, I totally based upon the hospitals. All right, any questions? from members of the committee. See none. Anyone here to speak for or against this bill. See none. You're recognized clothes for your bill. I thank you, and I know we know how much we need some more workforce out there to take care of maternal, uh, crisis we have in our state, so happy that this is again that we passed language to start. We have a certified nurse midwife program starting at UMMS in 2026, and we certainly want these midwives to stay here and practice in Arkansas and wants to train them and then to leave. I want them to stay right here and this will, will help a great deal for that. All right, thank you. What's the pleasure of the committee? Motion to pass. Second, all those in favor. I and opposed, I have it. Congratulations. You passed House Bill 1181. Thank you, Chairman, for letting me run both those together. I appreciate it ma'am. Thank you for being here today. Uh, Senator Boyd, you're recognized to present Senate Bill 139. Thank you, Madam Chair. Senate Bill 139 is the bill that I've presented twice to this committee already regarding uh physician non-compete clauses, and so I don't know that there's anything else I have to say, OK, are there any questions from members of the committee? Senator Hill, you're recognized for a question. Senator Boyd, I support your bill here. My biggest issue is that it does not go far enough. As as we're in the medical field right now, we we look at a shortage of nurses and everything else that we're having and these nurses, whether it be an RN, CNA, or whatever they are, or other professionals in the medical field. They're all locked into these non-compete clauses in their, in their, uh, facilities where they work at or it can be at an individual's office that prevents them from going somewhere else. As we are in a shortage for medical care professionals. Can you answer why we're locking these individuals down when they were it affects the health of all people in Arkansas. Senator, I cannot, what I can say to you is I agree this bill does not go as far as I would like for it to, but, uh, as I worked to develop it. Uh, I, I understood some concerns and so, but that said, I am more than happy to co-sponsor a bill with you that goes further. All right. Any other questions from members of the committee. Seeing none. Is there anyone here to speak for or against this bill? See none. Uh, you've closed for your bill. I would appreciate someone, Senator Filippo, give me a due pass and someone second that. OK, what's the pleasure of the committee? Motion and 2nd, all those in favor say aye and opposed. I have it. Congratulations, you've passed Senate Bill 139. All right, let's see, we'll move on, um, Senator Wallace, if you'll take the chair, I'll do HB 1427. And then we'll go to Senator Penzo after me. And ma'am, you were recognized. Thank you, Mr. Chair, members of the committee, I won't speak long. This is the ability you've already heard, the healthy moms, Healthy babies Act. This is the house companion bill. Happy to answer any questions. OK. Members, are there any questions? I the Central Love, I didn't see it. Thank you, Mr. Chair. Um, Madam Chair, why do we need it? Why do we need a house bill in the Senate bill just good enough, you know, such a good bill we needed 2 of them. All right, thank you I appreciate you, Senator Love. And members, we have one person that would like to speak against the bill. Mr. Lamar Porter. Sir, if you would identify yourself. My name is Lamar Porter. I come here as a private attorney who's handled birth injury cases for decades. I am not against the overall thrust of the bill. I'm here to speak about requiring Babies, their parents to bring lawsuits in the situation of a birth injury. Within 5 years. I represent the parents and children of victims of malpractice. I don't represent health providers. I don't represent insurance companies. I am here Opposing the proposed limitation for this certain class of birth injury victims. From Now having a statute of limitations, that's 5 years versus 11 years. It is ironic to me that a bill designed to promote the health of moms and their babies. had added to it a provision that potentially harms the legal rights of moms and babies. Statutes of limitations serve to limit the rights of injured injured individuals. Adults are imposed with the obligation. Of knowing their right to sue. In the area of statutes of limitation. In recent years, The legislature has imposed obligations upon parents to protect the legal rights of their children, regardless of the circumstances. The recent attempt to change the statute of limitations for childbirth cases only is constitutionally suspect under the Equal Protection Clause of the Constitution. equal protection means a statute can't create impermissible. arbitrary Classes of rights. That are unequal. What is it about malpractice during the delivery process. That is different from malpractice at any other point in the baby's life. Before delivery, after delivery. So this Change to the statute of limitations, creates a shorter statute of limitations for a child that is injured or dies during childbirth and a longer statute of limitations for minors suffering, medical injury before or after the process. There's no legitimate reason for that distinction. You know, there was discussion before, I think, I was not present, but I understand there was comment about surrounding jurisdictions and what kind of statute of limitation laws, do they have? I looked, none of them have a law that provides a specific statute of limitations for malpractice taking place during the delivery process. This Change to the statute of limitations. Would also create the potential for statutes of limitation. Say there's Malpractice during the prenatal period of time. That's going to be age 11. But then, oh, well, there's malpractice during the delivery process. So that's age 5, and then, well, what about when the baby's being transported if they don't resuscitate the baby and maybe there's malpractice occurring at separate periods of time. Do we have to or 3 different statutes of limitations for parents to have to. No, act on to the courts gonna know how to deal with those situations without further guidance. Uh, So, You know, from the birthing process. is a complicated process. Are we going to say this statute starts within Uh, or the lower statute limitations begins when mom goes in the hospital? Is it gonna be? At the point, she starts contracting? Is it going to be the part where she starts pushing in second stage of labor. Is it gonna extend until, well, they're resuscitating the baby in the delivery room. Or maybe when the babies still in the hospital, uh, it creates confusion that creates work for attorneys, courts, And Who benefits from all of that confusion. Certainly not. Mom and her baby. While some of these questions may appear to be minor, in fact, I contend they have major implications to the statute of limitations. We have a client, Kayla Pickett, who wanted to be here but could not. She would tell you she recently filed a lawsuit. Uh, shortly before the 2nd, excuse me, before the 11-year statute of limitations expired. She wanted to explain to you why it took so long. She was going to explain the factors in her life. And that, uh, her child that delayed her ability to bring a lawsuit. A lawsuit that was never at the top of her list of priorities, because she was trying to raise a daughter that could not talk, walk, was blind, and required 24/7 care. Kayla would tell you under the proposed change to the statute of limitations. Her daughter would be crap out of luck. She would have told you that she would have had two different statutes of limitation to worry about. Members of this committee, miners are incapable of protecting their rights. Parents don't always protect the rights. Of the children Frankly, I think 11 years too soon. You know, used to be minor had until 23 years after the age of majority to file a lawsuit. That was decades ago. Slowly, the rights of the infant. have been Whittled away. And this is an attempt to whittle it away further. Medicaid pays millions of dollars for these kids. Medicaid rides the back of the pair when it comes to these lawsuits. Oh yeah, there's a provision that says Medicaid can bring a cause of action on their own. They don't ever do it because they can't afford to do it and they don't know how to do it. This impacts Medicaid's right for reimbursement. I would submit we're going the wrong direction when it comes to protecting minors. A proposed section 4 paragraph 3 of the Act be removed from the bill so it can be passed and used to protect the rights of mothers and babies and not used to diminish their right. Thank you for the time. I'm open for questions. I'm obviously an interested party here, uh, but this has been my life over many decades. Senator Payton, sir, you're recognized. Thank you, Mr. Chair. So If, if you have liability insurance and one of the, one of the reasons it was given to me for, for having this paragraph in there is that Uh, doctors who deliver babies want to retire and somehow they're forced to carry their insurance. Beyond their retirement. But I don't understand that because I've been involved in other types of liability claims. And if you have insurance, liability insurance. And you have a claim. It's based on whether or not the insurance was in effect at the date of the Accident Is there something different about this type of liability insurance? It says they have, they have to maintain coverage until the point of being sued because tail. They have to buy a tail that covers them, uh, beyond when they stop practicing. Is there any other type of insurance that is that way? I mean, Like a, like An automobile insurance where you have a liability claim. The person whose liability insurance is being Sued or, or responsible. They may have missed their next month's payment. They might not have made their payment. So, so what if the doctor has done a malpractice and, and he's He or she is is a Liable for the damages. And they went bankrupt and quit paying their insurance premiums. I mean, I don't understand how we could have a, an insurance situation where it's based on whether or not the next premium was paid rather than whether or not it was in effect at the time of the the liability. Well, I will profess I am not an insurance expert. My response would be, Who do we want to protect the children's rights or a doctor who is Has been practicing, took the risk during the time is paid insurance premiums. I mean, or the insurance company, add that in there, you know, the insurance company. I mean, you know, maybe insurance companies ought to have to cover, uh, and not charge more premiums once somebody has quit practicing. Well, and I appreciate the fact that you may not know the answer to that, but I, I do believe that if somebody has insurance coverage at the time of the accident. That that insurance should be responsible whether that accident is revealed immediately or 6 months later or 6 years later or whatever because if their coverage is dependent. On the fact that they continued to pay premiums, then we don't, then, then we have a false sense of security. As a customer, I appreciate your answers. Thank you. Senator Love, sir, you have a question. So Mr. Porter, I hear. I'm, I'm trying to follow what you're saying, but this is, this is something that that I'm interested in, so. Um And, and, and you bought it, you bought it up a little, which made me start thinking, so I have a daughter when you bought up Medicaid, that's what really kind of so I have a daughter that I adopted. Um And this may not be an entry, but I want you to. Answer this. I have a daughter in which she, she needed cranial vault surgery because the sutures in her head, they. After you guess after delivery, they fused. OK. Now that was something that basically was missed. With this law and With this law impact something like that or are we talking about uh damage that was done by a doctor. I'm, I'm trying to, I'm trying to figure those two things out. When was it missed? It was missed at birth was missed at birth. So it could be a birth injury. Five-year statute under the proposal. But It obviously was not picked up for a period of time after the birth. So you have that dual statute of limitations issue, you may have a birth injury five-year statute. or If somebody missed it a month later. And they could have taken action and prevented the consequences, then you've got the 11-year statute of limitation. So it just It just compounds complicates things. Why do we have to have different rules for doctors. Who deliver babies. Compared to doctors who make any other form of negligent mistake. It doesn't make sense, and I, I question, you know, I pay insurance. I pay malpractice insurance. It's part of doing business and When I look at brain damaged babies where moms care for those kids 24/7. And I'm not going to worry about what the doctor's insurance premium is, as long it's not driving them out of business. And that used to be touted years ago. Oh, if we don't do this, then doctors are going to be drawn, you know, knocked out of business, whatever. They're going to leave Arkansas. None of that ever happened, but that was a selling point. Going back decades for laws protecting the rights of doctors over the rights of patients. Senator Penzo, you're a recognizer. Thank you, Mr. Chair. So I have a problem with this section as well and. I don't know that I caught it the first time, uh, I read it different. I have an issue because the 5th birthday is when they're going to kindergarten. That could be when their teacher catches that they're not up to par with the other students and then testing starts at that period and that's when they find out that there was an issue. Um, so that I have an issue with that. Senator Payton was mentioning, you know, insurance and, and we're talking about this tail insurance that they should be covered if, if the, the act of negligence or whatever it was occurred at delivery, they should be covered. They shouldn't have to carry tail insurance. So, uh, in your opinion, you probably agree that um this needs to be fixed at an insurance level instead of reducing the statute of limitations on a a new board delivery, correct? OK. So I guess my question would be why, why, um, Are we doing it this way instead of Addressing insurance. Uh, stuff at that time, so, uh, um, and like I said, I didn't really catch this, so if that could be addressed, uh, I, I'd appreciate it at some point. Yeah, whenever you Get up close. Any other questions? Members, are there any other questions? See, sir, thank you for your test. Thank you. I, um. I'll address Senator Penzo's questions, but we also have somebody here from Medicaid that I think probably should speak about the conversation that was had about Medicaid, um, and if I would actually like for them to come to the table and just correct the some of the statements that have been made. Would you all please come to the table? Please identify yourself. Good afternoon, Janet Man, DHS and Medicaid director. What was the Can you repeat the question in closer to you. So some of the, my question as a member of the committee actually, but, um, is talking about Medicaid bringing, bringing, um, action. And, and if If this would affect Medicaid bringing action and lawsuits. Um, not to my knowledge, OK. I just wanted to make sure that was clarified for the record. Members, Senator Love, you're recognized. OK, thank you, Mr. Cha. Now I guess I'm trying to, I'm, I'm, I'm kind of confused now. Are we talking about Medicaid does Medicaid bring lawsuits? We have in the past depend depending on the case. I, I, I'm, I wanna make sure we're not confusing Medicaid and DCFS because Medicaid can bring lawsuits for different reasons with services being delivered. But you also brought up an adoption, so I don't want to compete to me, that would be two different issues. They're talking about malpract we're talking about malpractice during delivery. OK. Thank you. They're different things. Members or are there any other questions for the witness. Senator Payton, sir, you're recognized. Thank you. I guess this wasn't something I was focused on, but I don't understand how If Medicaid brings lawsuits, how this would not affect them. Because this definitely limits. Their ability to bring a lawsuit. I'm not sure about initiating lawsuits. We would, we would, um, probably be a party to the lawsuit as one of the, one of the providers and the payers. How could this not affect you when it's, well, I think the testimony was that did they initiate them on their own. And, and we have initiated lawsuits. I'm not gonna say we've never initiated a lawsuit, but I'm saying is it would depend upon the, the circumstances of why we would initiate what we're there's an award, you may recover some of your medical expenses as why you would participate participate for, um, medical records and testimony. Yes, sir. I don't see how this wouldn't affect you. OK, thank you. Members, or are there any other questions of the witness. Um, so I will address the issue that Senator Penzo brought up, um, separately. Um, the reason there is tail coverage that has to be covered and, and that is a separate issue. That's not what this bill does, but there is tail coverage that has to be purchased. So, for example, um, Mr. Gilmore, who's an administrator down in the hospital in South Arkansas, um, could not find OB-GYN doctors. They've retired and Obiy's doctors will retire. from delivering babies because of this um tail coverage that has to be provided and sometimes that's paid for by the hospital. Sometimes it's paid for by the doctor, depending on their employment contract, but that tail coverage does have to stay in place until that statute of limitations is um up and so in that case, in this hospital, they had to close their labor and delivery units, but they still have to pay the malpractice insurance tail coverage even after they have no obedience and they've closed their label on delivery units. And so it is a tremendously expensive bill that they have to pay for every single year without the income of being able to deliver babies. And a lot of times your OB-GYNs will stop delivering babies, the OB part, and they will continue to practice as gynecologist, but the, the issue at hand is the fact that we are way below, um, Trying to get doctors and particularly OB-GYNs to come to our state, and it is incredibly difficult to recruit OB-GYNs into the state. It is absolutely proven. You can talk to Mr. Gilmore who's tried so hard to recruit OB-GYNs to replace his retiring ones, and they had to close their labor and delivery unit there at that hospital, but they're still having to pay that malpractice tail coverage insurance. And so this is aimed at really trying to help stabilize our healthcare infrastructure of labor and delivery units. Women have to have a place to deliver their babies. And right now in the state of Arkansas, we are, um, only 35 counties, I believe, 3434 hospitals in the state of Arkansas now with labor and delivery units, only 34, and that has dramatically decreased, and that's what's leading to a lot of our problems and complications in maternal care and infant mortality is because these women need to have a place to go and deliver their babies closer to where they live. And these hospitals, particularly your rural hospitals, cannot afford this. They can't afford it. And so we've got to do something to address the problem and this limits of such a limitations at 5 years, I believe is generous for Louisiana, it's one year for Tennessee, it's one year, and for I think Mr. Mississippi and Oklahoma 7 and 8. Texas is 14. And so we re we kept these additional statutes of limitations in the bill because I felt like it was important because that speaks to what you're talking about in a surgery or something, a surgery, then it would be different. We're talking about when the baby is being delivered. 5 years. You should know, and you're, you're going to know soon after delivery, if something is really wrong. with this child. And so, we've looked at that data, we've looked at those additional statute of limitations, and we believe that this was the right, a right balance, and we wanted to maintain those previous, um, statutes, uh, because we felt that was the right thing to do. So we didn't change those. We added this one provision. Senator Pino, you're a recognizer. Are there any other Doctors that have to have this tail insurance or is it just delivery docks. I don't, I, I would have to defer. I'm not sure if the medical society can talk to that or not to speak to that. Mike Mitchell might. Are you still here? Thank you. Sure if you will, please identify the cost of malpractice insurance has skyrocketed as well. Mitchell, I'm general counsel Arkansas Medical Society, uh, the general statute of limitations in medical malpractice is 2 years. Now, that's different when it comes to minors and the legislature has extended that out when it comes to minors, but generally, the statute of limitations in Arkansas is 2 years for malpractice case. So, so the question was, are there any other doctors besides, uh, doctors that perform deliveries that have to have tail insurance after they retire. That that do what? After they retire, of course doctors have to all doctors again, we've got a claims made policy. So in Arkansas, most of the policies are claims made. So when the claim is made is when it's determined the insurance uh that covers it. So it's not uh when the accident occurred, that's called an occurrence policy. So it's, it's all doctors, uh, it's 2 years. So, so in, in, in this statute here, it's it's 2 years. For the age of uh Is it 11, whichever is later. So you still have the 2 years in there, but we're covering children so the pediatricians Have to have an 11 year tail after they retire, whether they're delivery or not. That's right. OK, so, so we're only, we're only doing this for pediatricians still have to have it. This would only it, it's not directed so much as as the physician, but the minor. It's the fact that a child statute of limitation is longer than an adult. I understand that, but we're setting it back for OBGYNs that deliver. Where pediatricians still have to carry it for 11 years. We're only making a carve out for OBGYNs, is that correct? That's my understanding, and, and again it speaks to the fact that we're, we are down to 34 hospitals that have labor and delivery, and we are trying desperately to replace our retiring OB-GYNs. Centripeton. Thank you, Mr. Chair. I don't know if I can articulate my question or not. I mean, it seems to me like we're protecting the insurance companies more than anybody. They're the ones that are Selling their product to protect the doctor and then they're not protecting the doctor and therefore we're having to change the law to protect the doctor because The insurance companies are selling a product that isn't protecting the doctor. So, so here's what I'm saying. You've got a doctor that says I'm, I'm entering into this field that has some inherent. Dangers or or problems and you have an insurance company that says, We'll, we'll take over your risk. And we're gonna sell you a product to cover your risk. They have to evaluate their risk in order to set the price of that product. But when the doctor quits practicing, their risk has ended. Now I understand that they may not know of claims yet. But, but those actions have already taken place. They ensured the doctor for a period of time when he was practicing that he or she was practicing. Their risk doesn't increase. Down the road when the doctor retires, it's slowly fading away. I really believe that we should address this paragraph. I love the rest of the bill. I really believe that address, that paragraph should be addressed to our insurance law. I don't, I don't understand why we'd let the insurance companies get away with this. Senator Payton, that It's because of the statute of limitations that's in legislation that requires the tail coverage. The, I mean, this actually reducing this for just this OBGYN. OB-GYNs are the 2nd most sued doctors in the country. And so when you're a young medical student, That's going to be a factor as to whether you're going to go in and be an OB-GYN or or not. That weighs into their decision because guess what? I have to practice medicine and carry coverage the entire time I'm practicing actively and delivering babies, but then after I deliver babies, 5 years post or 11 on all that. I just think we're allowing the insurance companies to extort them because they're in a high risk field. Well then you would, then you would just eliminate the, I mean, yeah, I don't disagree with you. I don't want to offer protection to the insurance company. We're not to save the doctor. Well this is an offering protection for the insurance companies. This is actually reducing the amount of years that they're going to be paid with tail coverage, so I don't think they would be for that, but I, I hear what you're saying. I guess you would just then limit all statute, you would just take all statute of limitations down to 0. It's a statute of limitations. Insurance companies is just covering the exposure. But they're not the statute. They're only covering it if you continue to pay. They're not covering it for the time period that they covered the doctor. They're not, they're not. Their coverage is dependent on whether or not the doctor continues to pay beyond the occurrence of whatever created the liability, OK, but, but if you don't carry your tail coverage, then you're completely exposed and you're going to lose your house and every single thing, if you get sued. I mean, that's why you have to have tail coverage because then you get wiped out, you lose everything from a malpractice insurance I mean from malpractice is that they have to have it. Right. I don't, I don't disagree with you. Thank you. Thank you, Mr. Chair, to love, you recognized. Thank you. I just wanted to ask you, so what is the cost of this tail coverage, the cost, yeah. Well, it's malpractice cover whatever the whatever the premium is. OK, so you have to extend, keep paying it for the 2 years I want to ask you what is the average premium, I don't know that. I I it varies depending upon the the the type of practice and, but I, I couldn't give you, you'd have to get an insurance person that knows the premium rates, and I don't know that. I don't know either. I, I do know that it can be incredibly incredibly expensive. Of over $100,000 a year. For some of the specialties. And that that's not exaggerating. It's incredibly expensive. And so it becomes very problematic when it's a hospital that then has to continue to pay the tail coverage even after there's no doctors there delivering babies and generating any income to offset that bill. And that's why this is included and why we put it here. I mean, we felt 5 years was a good number, based on, you know, what we had seen. otherwise. But, but it can be upwards and I will just say it is also problematic because at one point in the state of Arkansas, the main malpractice company, um, insurance company that was covering pulled out of the state of Arkansas. And it actually left our hospital there in Mountain View without coverage, um, and it, you know, when you only have one company in the state of Arkansas providing malpractice insurance. You can imagine what happens to the premiums. Just go, Scott, because there's no competition. So it it left everybody really scrambling. So, um, it I, I don't know the answer to that question. I can find it for you. As best I can. And Senator Penzo, sir, you're recognized. Kind of, kind of what Senator Payton was touching on. I don't think I, I know the answer is going to be because premiums will go up while they're practicing. But I think where we were going with that is. You're covered When you're employed by the hospital treating patients and then when you're done treating patients, that doctor's liability should be over at that point. I mean, I know that's not how it is, but that's how it should be structured. To require someone to pay insurance in case they messed up when they were covered, they, the insurance companies are Double dipping on in, in my opinion, from my perspective, and I think that's kind of where you were going with the wire, it's insanity that they're having to pay insurance when they're retired. In the tune of, I mean, OK, you know, why are they not just paying insurance for, I mean, I think that's what we need to be addressing instead of But cutting the statute back on a child that can't tell you that they're injured. That's the the reason why it's up to 11. It's because children can't communicate their issues. That's why there's a higher level. So like I said, I think we need to be addressing. Uh, insurance issues instead of statute of limitations on injured children. I mean, and I don't know how we go about fixing that, but I mean. Just to be clear, Senator Penzo, the insurance and I'm not here to defend the insurance industry at all, but they're just covering the exposure that the statute of limitations allows, so all they're doing is covering that doctor who might could get sued, you know, years after they quit practicing and I understand that, but it should be rolled into their insurance when they're practicing is what I'm saying. Because I mean it's some people might not carry it and then they lose their house like you said. Or, but I mean, adjusting the statute of limitations on newborns is. I have an issue with that. I I understand, again, like I said, we worked to try to find what we felt like was the correct balance and I believe that this is the correct balance, uh, to address our maternal health crisis that we have in the state. We have a maternal health crisis in the state of Arkansas. One of the main reasons is because labor and delivery units are closing all across the state of Arkansas. This is one of the factors that completely contributes to labor and delivery units being closed. It is one of the main factors that does contribute to our inability to recruit OB-GYNs and maintain them, and to keep them delivering babies longer. We need Oi to deliver women's babies. That's what we need. We know that this is a problem. We know this is an issue. We know how costly this is. I don't think it was right to remove the statute of limitations down to 0, because that's what you're advocating for, I'm not sure that would definitely wouldn't have, I, I don't think that would have been the correct thing to do. So, again, this is, this is where we're at with the legislation, and I, I appreciate a good vote. Members, are there any other questions? See none, said Irving, have you closed? I have. OK. Members, we have closed. Senator, would you like to make a Motion to pass. Do you have a question, sir? I'm sorry, discussion. Where was I moved DuPont we're, we're in discussion now. I just want to clarify that I was in no way advocating for a zero-year statute of limitations. I was saying that we should get rid of The, the insurance company's ability to mandate tail insurance for coverage, the all the, they should be covered while they're practicing, and that's when they should pay their insurance. I just wanted to clarify that I was not advocating, I was advocating for it to be back to 11 years, uh, where it was before this bill. Thank you. Senator Payton, sir. Thank you, Mr. Chair, and Senator Irvin. I don't want to be misunderstood about my, by my questions and my arguments. I do believe that we have a problem with the insurance companies here, and I do believe that it would we'd be better served to address it on the laws for the insurance companies. However, when you're sick and you've got a fever, you need antibiotics, but you're gonna take the aspirin or the fever reducer until you can get the antibiotics. So I'm gonna vote for this bill because I feel like it's a, it's a treatment, but it's not the cure. I, I would hope that Somebody, maybe an insurance and commerce would work on the cure. But uh, but I think it's a sad state of affairs that we have to. Restrict The injured parties Uh Opportunity for recovery because the insurance companies Or uh involved. Thank you. Thank you, Mr. Chair. Members, are there Other discussion, is there any other discussion? See none Senator Urban has made a motion. Do we have a second? I have a 2nd. All in favor say aye, and you polls, say nay. Congratulations, you passed your bill. Thank you, members of the committee. Yeah OK, Senator Penza, Senate Bill 99. I have you with Senate Bill 99 and 101. Is that correct, Senator Penzo? Actually, uh, the physician assistants asked if we could push all their 3 bills back to Um, Wednesday, so they were, we were going to do one then, so they asked for the other two to be ran at the same time, um, as far as today goes, uh, if, uh, Do you just want to wait then? Yeah, I can do Senate Bill 119. 119, that's uh. will be pretty loaded up Wednesday. Senate Bill 119 is now incontroversial. It should be pretty. Yeah, there's, there's Do you, um, OK. OK, we're gonna, we're gonna wait and do this one Wednesday as well. OK. In the meantime, I am going to pass out his handout, so just keep it in your folders, members, um, for Senate bill. 119 and then try to amend and get a house member put on there before we run it. That way it'd be ready to go. OK. Members, um, we're not sure if we're going to have public health on Wednesday or not, uh, depending on the weather, so just please watch your phones and we will, um, notify you whether we're going to have it or not. I am inclined not to have public health Wednesday at 10 because I know education has already been canceled. So it looks like we probably won't have public health Wednesday at 10, uh, Your question you texted me earlier, so. It'll have to be next week. Yeah, if that's OK. OK, all right, because I know people have a long way to get home, um, in case you need to get home because of the weather. So, I think for the purposes of the members of this committee that live far away, I'm just going to go ahead and call it and say no committee meeting on Wednesday. Do you have any input, anyone? Just in the questions is this supposed to be scope week, I guess we'll just make next week's Scope week, and then those bills will take precedence over everything else. OK, we just try to designate Scope week so that everybody's prepared of this is what we're going to be dealing with, um, the date was February 13, so after February 13, they can all run based on our rules. We'll just, we'll just We'll just have to work really hard next week. OK, thank you all members. We're adjourned.