Public Health, Welfare and Labor Committee - Joint
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- October 2, 2026
of the april 1st minutes have a motion do we have a 2nd 2nd all those in favor say aye post motion passes all right we have some guests with us today if you'll be making your way to the table we'll recognize you guys for a presentationembers I think you have a handout and it's also obviously going to be on the screen.
Senator Missy Irvin
Unverified
2:38
Thank you Mr Chair. I appreciate everybody coming today. excited about having this discussion that we have on the agenda coming up next I wanna say if you attended our meetings down in Texarkana and I believe Arkadelphia, right and thatate where we went Aradelphia to the hospitals but one of the big topics that came up in those meetings down in Texarkana was about homeless population and what the county judges and county sheriffs were facing and as you
know we've had chrystal stabilization units we've passed legislation however, really only one has been able to be sustainable. the others have not been able to be sustainable so and with that legislation that created the crisis stabilization units we kind of did away with some policy that I think probably needs to be reinstated for our local law enforcement officers and agencies because they need to be able to
have a se2ho hold capability because they have no place to take some of these folks and so I think this was discussed this discussion began at some of our previous public health meetings and we're hearing from not just those in healthcare but law enforcement and how they're trying to deal with folks that are homeless but also have severe mental health issues and substance abuse issues and things like that so it's a it's a it's a very big complic ated discussion so if I'm excited to have everybody here to to really have this
discussion. Thank you Mr chairir. thank you to the
coachchair for those comments if you're at the table we're ready to recognize you to present if you will state your name and who you're with for the record and then you'll be recognized for your presentation. Good afternoon my name's Danny Baker
Danny Baker
Unverified
4:29
I'm the police chief in the city of Fort Smith I appreciate the opportunity to be here today and and be part of this discussion. Hi, I'm Heather Webb. I am with Arkansas Family alliance and the
Speaker 17
4:43
former director and still consultant for community rescue mission a family homeless shelter in Fortsmith.
Speaker 20
4:51
good afternoon my name is Paul Webster. I'm a senior fellow with the Cicero institute and advocacy
Speaker 22
4:56
in public policygan organization out of Austin
Speaker 24
5:01
Texas. my name is Rusty Holwick and I'm the CEO of western Arkansas counseling Guidance Center we're a community mental health center and a grant funded certified communityhavial healthal clinic. We cover six counties in the
Chair
Unverified
5:13
most western part of the state thank you. I'marren Phillips and I work for restsore Hope. I'm the chief operations officer for restore hopepe and restore hopepe housing and we currently serve 19 different communities in Arkansas. Hi'm
Speaker 28
5:34
Ben Goodwin. I'm the executive director of our house a program here in LittleRock that serves homeless families and individuals and helps
hundreds of homeless people find jobs and achieve
stability each year. well thank you all
Speaker 31
5:50
for being here and you're recognized to present thank you so much
Speaker 20
5:55
I appreciate the opportunity to address the committee and as a policy analyst I'd like to provide a very brief overview of Arkansas data on homelessness and highlight some recent federal reforms that can benefit Arkansas and recommend some ways Arkansas can lead on homelessness and assisting the most vulnerable in our
communities I'm joined here by my colleagues and after my presentation I just love to have kind of Q&A in discussion with them because they all represent different facets of the response to homelessness and different programs that are doing great work of to deal with this issue let me see here we go. this this statement here the debate about homelessness policy is no longer whether people need help
it's it is what who gets to define what help looks like and what happens when someone refuses it. what help is the right help for people who clearly need help. Second what is the best way to provide such help and what obligations exist for both those who provide it and those who are offered it and third how does enforcement of laws and social
norms come into play when bad actors attempt to take advantage of the charity offered to them. My view is that government has an obligation to provide help to those who are in need and those who are in need have an obligation to accept that help what has happened in many communities that the wrong help for many people has been made that only help has been made the only help that is the wrong way for many people has been made the only
help because it's been tied to federal funding. The result has been significant consequences regarding public safety, public health, civil disorder program performance and accountability and the lack of treatment for the most vulnerable. in case you're unaware the federal government has a program that they call the continuum of care program and this program has created entities in every state in almost every community
called continuums of care. Arkansas has5 continuums of care and you can see on the map there where their geographic designation is the locus of homeless policy and resources across the country are these continuums of care and they are the entities the federal government has established and designated to coordinate housing and services and distribute federal homelessness assistance funding one of the challenges of the current system has been that COCs have promoted solutions
determined by experts from Washington DC instead of empowering things that work locally said another way the state county and local governments here in Arkansas have no authority over these federally funded entities and the priorities and activities and subsequently COCs in states are often at odds. Another challenge is that homelessness has become a political issue that demands more and more money for results that are just not clear increasing housing
affordability is laudable but not if it fails to reduce the number of people living on the street in the woods or in public places this next slide is an amalgamation of both federal funding that comes to Arkansas represented by the green bars and the federal point in time count represented by the black line which is the total point in time count the yellow line which is the number unsheltered individuals in Arkansas and the blue and other lines are basically chronic homelessness,
homelessness with people who have mental illnesses and homelessness with people who have subs t ance use disorders the 20 year data of funding and results are a mixed bag in Arkansas. COCs have received around4 million dollars a year for the last 15 years and homelessness after initial decline has stayed about the same with around 2500 homeless statewide,1,200 unsheltered and600 each with mental illness and substance use disorders. this flat funding and
count estimate is important because the effectiveness of interventions change over time what used to work in 20 2005 doesn't necessarily work the same way in 2026. Other states like Utah are focused more on treating addictions and untreated mental illness then the provision of housing and they're doing reforms that are very interesting to address the challenges because as you can see here unless we do something different you're basically gonna get the same results
the next slide is the Arkansas housing inventory what this means is that the amount of housing that has been created in Arkansas to serve specifically individuals that are experiencing homelessness and what I've done is I've juxtaposed the roughly the point in time count my research and the research of my colleagues show that the provision of subsidized housing for people experiencing homelessness does not impact the number of people that are homeless. let me say that again we're giving subsidized housing
and dedicated housing for people who are experiencing homelessness but is not reduced the number of people that are living and dying on the streets in communities all across the country and partic and here as well in Arkansas so why is this? well one of the reasons is the state of homelessness these these graphs are from a 2019 study of the largest number of unsheltered people surveyed in the country64,000 unsheltered
people and if you look at the graph on the right side it clearly shows that there's a huge difference between folks that are sheltered and folks that are unsheltered and you could see that about78% and75% respectively of folks that are unsheltered have some kind of mental illness or some kind of substance use disorder and I'll and and I really want to focus in on the disparity between the number of folks who were in shelter who have a substance use disorder at 13% and the number of folks that
have a substance use disorder that are unsheltered at75%. what does that tell you? Well that tells me is that folks with substance use disorders don't seek shelter and conversely what that means is that they're typically on the street so the the the it's clear that the systems addressing mental illness and addiction oftentimes fail and are producing the kind of streetle destitution and disorder that garner's press headlines impacts public safety
and results in serious public health outcomes So what communities what are communities dealing with? Well I think my colleagues will be able to speak to this better than I since they know what's going on in their communities but it's it's really these these six things housing and shelter in other words where can people go? addiction and mental illness particularly untreated addiction and untreated mental illness, the impacts of crime and public safety on community the
accountability for funds community funds and whether or not they' re actually reaching the outcomes that the state and the community desire the challenges of resources and regulations I showed you before that out of the five continuums of care across Arkansas the federal government is providing about4.6 million dollars a year and that's it the state of Arkansas provides $0 and then bad and insufficient data. when I ask legislators and city
council members is homelessness going up going down or staying the same a lot of times they can't answer and the reason that they can't answer is that there's not good metrics and milestones there's not good data to determine whether or not if things are improving if things are are are not improving and why so it's important to know those things when at the Cicero institute we work with cities and state to address these issues and we advocate for statewide camping bans and enforcement of public rights of
way increased access to treatment for serious mental illness and substance use disorder enhanced penalties for homeless providers that tolerate crime and drug activity. accountability for state homelessness funds transparency and reporting of spending and activities focused on outcomes integration of treatment and housing consolidation of continuum of care to reduce regulatory and resource barriers improved data collection and reporting. I can go on and on
with the number of recommendations and interventions we have to allow states to get a better handle on what's going on in their state and in their communities but I'll I'll leave it at that and maybe we could talk a little bit more about other dis in in our in our discussion. The good news is that over the last year the Trump administration has done some really terrific work in terms of homelessness reforms instead of focusing specifically on the creation and subsidization of what's called
permanent supportive housing for people who are experiencing homelessness there's now greater flexibility in the types of housing that federal funds can be used so that boarding cares or supportive communities or rehabilitation programs can now have access to some of these fundings there's a greater focus on the unsheltered the population is growing the fastest than on just folks getting into housing the Trump administration had waived prohibitions on participation requirements so that programs can hold people
accountable they're more outcomes focused there's a greater priority on data transparency and a greater focus on what is going on actually in the community the president's executive order on crimeme and civil disorder empower states to prioritize civil commitment enforcement of drug laws integrating treatment and housing and removing barriers that states and local governments face in balancing the needs of vulnerable individuals providing for public safety and increasing accountability and outcomes and
these reforms are the biggest policy change addressing homelessness in the last 20 years and provide a solid platform for states particularly states like Arkansas to put resources where they will be most effective and make the biggest difference from the homeless and communities and I wanna I really wanna focus in in detail and and kind of give you all a sense of exactly what I'm talking about this slide shows the 2024 point in time count numbers for people who are homeless in general
across Arkansas folks that are unsheltered the number of unsheltered who are estimated to have a serious mental illness and an addiction and the number of folks that are in shelter that have a serious mental illness and an addiction what you see here is that in Arkansas they're according to the 24 data there are about 28 folks that are that are homeless across the entire state of that 2800 about half or 1300 are unsheltered that are living in the woods
they're living on streets they're living in parks. Out of that unsheltered about42% of the unsheltered have some kind of serious mental illness and or addiction so the old adage is if you want to eat an elephant how do you do it? One bite at a time. we know that if we can identify these specific populations and subpopulations with specific interventions then we will be able to have milestones and
metrics to hold communities and hold state agencies accountable for how we're actually meeting those milestones and metrics and what this also does is it provide s for an opportunity for state funded and community based organizations to align their objectives better with what is happening in the state to be able to collect and report data on whether or not they're actually reaching outcomes and see if what they're doing is
what the state is technically is is potentially paying them to do better monitoring and identification of homeless sex offenders which make up nationally about 20% of the unsheltered homeless population and diversion for unsheltered individuals with outstanding warrants will impact the majority of the 1300 unsheltered in Arkansas so that gives you just a real kind of a specific idea about what can happen in the state of Arkansas to address
this population and start making gains instead of just kind of letting the status quo rule and getting the same results my last slide shows some recommendations on how Arkansas can lead one thing they can do is establish the certifiedunhavioral healthal clinic programme statewide by submitting planning grant to the federal government through SamMSAnother one isll collect bettert data and require communities to collect better data and report better data require improvements in self
suffici c ies for state funded grants if the state is funding organizations to attempt them to reduce their reliance on state programs then have some outcomes and metrics to actually show if they're progressing or not reforms civil commitment laws and processes so these very vulnerable people who have serious mental health and addiction needs can get the help they need without a bunch of legal wrangling and and delays that make their conditions even
worse. support law enforcement interventions and diversion programs be more outcomes focused and hold providers accountable for results. now is the time for Arkansas to engage on homelessness with less than3,000 homeless people in the state targeted d driven innovations can reduce street suffering, improve public and behavioral health and it impacts to communities The White House has created a pathway to addressing many of the most visible and challenging issue
s the legislature can follow this pathway to reduce barriers to treatment, improve public safety initiatives and promote self sufficiency and breaking the cycle of poverty and with that I thank you very much for your time and all of us on this panel are are here for a conversation and questions and to respond to questions thank you so much well thank you for being here I'm going
to recognize my co-chair Senator Irvi. thank you just curious
Senator Missy Irvin
Unverified
21:11
if anybody if those that are here and I wanted
to kind of focus in on what you talked about with the sex offenders. Now we we do have an Arkansas sex offender Manags association. I've worked with this team of people on legislative reforms. I'm just curious if y'all have had any conversations with them these are your frontline parole officers and sex offender managers association that that really are frontline interact ive with any and all sex offenders that are uh, basically
living in the public and out outside of the corrections have y'all had
Danny Baker
Unverified
21:51
any interactions or discussions with them? yes ma'am we have Fortsmith and our we we have a detective that is assigned specifically to sex offender registration he works very closely with those individuals I've had conversations within the last year about concerns of increased number of of sex offenders within the homeless population so we're very much aware of that and do our very best to make sure that we keep traffic of those
folks even as transient as as the homeless population seems to be we're certainly paying attention to that and staying in communication with those great thank you so much I
Senator Missy Irvin
Unverified
22:26
know we have lots of questions thank you keepep keep having those conversations great group of people thank you madam chairir. I have a question
for you and we've got several members in the queue and we're going to start with Representative Richardson next but the CCBhC model that you've talked about can you give us a little bit of an explanation on what that would
mean to the state of Arkansas and how that would be different than what we are currently doing. I know the planning grant I think is a million dollars that the state can apply for and help us get that initiative up and off the ground and I'm encouraging the department of humanman Services to take advantage of that and bring those dollars into the state of Ark an s as but can you tell us in your words and opinion what that would do for
Paul Good
Unverified
23:11
the state of Arkansas? Certainly and I'm I'm gonna speak very briefly and then I really like Rusty who actually administers the CCBhT program
Speaker 20
23:19
through Sama to talk more in depth about it but really what it does is it provides very necessary specific medicaid reimbursed treatment and services for people who specifically have serious mental illness substance use disorder and require crisis intervention and these are all medicaidcovered services under the prospective payments system so instead of relying on the very weak reimbursement of medicaid reimbursement for specific you know health
conditions CCBhCs are intended to assist the communities because we know that there are a lack of public state hospital beds for folks that are seriously mentally ill. we also know that there are challenges with respect to civil commitment issues so the CCBHC is intended to come alongside these communities and provide this very vital resource without expending a lot of money at the state level in addition the
state of Arkansas has the opportunity to specifically prioritize the kinds of treatment and outreach that they would like to see within the CCBhC program and let me give you some examples one example is homeless outreach. One example is jailbased treatment other example s are how do we integrate treatment with housing programs so that we make sure that folks aren't getting evicted because of the mental illness or
behavioral issue and so that we can maintain their housing and also provide these truly life saving resources so that they can be successful not only in terms of their health outcomes but also also with respect to their housing stability so I'm gonna stop there and allow reststy to talk a little bit more about that. thank you
Speaker 24
25:11
so much Paul by the way and one of the things I think to consider for Arkansas is it would be a shift in the way we're paying for some of those services already. not
additional cost and some of the behavioral health agencies or the CSSPsunity supporter providers already licensed and within medicaid within Arkansas can become as long as they can meet those lofty standards and that criteria can become certified as CCBhcs even some of those entities say like a Methodist or that serve only children, they could partner with somebody that serves adults and they then could become a CCBHC as well
in in 2020 we were awarded it was during the the height of the pandemic and the Trump administration at that time was pushing out these federal grants and so we were awarded a federalsamMSA grant. the funding allowed us to create the infrastructure basically that we wouldn't have had funding otherwise to do. We were able to train our staff in evidence-based practices and meet those lofty criteria same dayy access there's a a focus on crisis response 24/7. you can focus on
veteran services you can focus on justice involved. it really like Paul said it depends on the priorities of the state so for us one of the most effective pieces that we found when it came to homelessness was our act teams. it's an evidencebased model and it uses basically it's a sort of community treatment so you have a multidisciplinary team of people it goes from your psychiatric medical providers you have a licensed mental health professional, substance abuse provider a peer support person, people with
lived experience are are very important to the model and we wrap around participants. What works so much for us is that we've worked with specialty courts such as the mental healthal treatment court and the court's really have a piece in this of accountability. they seem to be the leverage that hold people's kind of feet to the fire and so that it really seems to be just a a perfect formula you know for outcomes and our outcomes have really been tremendous. so we have shown, pardon my voice, we
have shown I think7979% reduction in homelessness in these people 70 % reduction in time spent in hospitals.58% reduction in ER visits and a61% of time a person spent in treatment facilities. those are all very high costs otherwise spend and 84% less time in correctional f facilities and arrests so very effective. I mean if if if I could be
Speaker 20
27:52
so bold, I would very much encourage the state of
Arkansas to apply for that Samsa grant and in fact I know that there are about5 individual CCBHC clinic that are being funded throughammsa but you know Rusty's program has been so effective and had such good outcomes. my recommendation is take a look at her application and just you know say this is what we want to do it in the s at the statewide level I mean in my view when you've got a successful program that is meeting terrific outcomes at the local level it's
kind of one of the opportunities of the state to say how do we get more of this well we can do it by the state investing and actually taking advantage of the federal government's awards
on these absolutely well thank you for that and I appreciate that clarification Representative Richardson you're recognized but before I recognize you I do want to thank you for helping organize this presentation and put this together I know these are constituents from your district and thank you for your continued leadership on the CCBhC model and helping us push that forward so appreciate you and look forward to continuing to work with you
Representative R. Scott Richardson
Unverified
29:01
let me see if I can recognize you here. thank you Mr chair and and thank you guys for being here. you guys are doing fantastic work and one of my questions were already asking and the chair kind of dug into that with the CCBhCs. I guess my questions are more for you Paul right now from a from a large perspective and the work that you've done around the country and other states where where does Arkansas rank in terms of of homelessness and and and
improvements that we're making or
Speaker 31
29:37
not making. thank you so muchpresentative for that question and I wanted I wanna caveat
Speaker 20
29:43
it a couple of different ways on the one hand Arkansas receives the smallest amount of awards per capita of homelessnos in the in from the federal government of any state in the country so you all are receiving the smallest amount of money from the federal government to address
homelessness that being said when you look at the point in time count, you know everybody talks a little bit about you know graphs and how you want to go from you know, either topright or bottom left to top right or from top right to bottom left right? Are you going up? are you increasing or are you decreasing well Arkansas unlike many states are is actually kind of holding steady so when you look at the amount of money and when you look at the the point in time counts and and I also like to
say that the point in time counts aren't the best measurement but they are a measurement and they give you an idea of what's happening year over year to determine if things are improving or or or not improving so I would say that you know in terms of the actual trends Arkansas is kind of like in the better half of states in the country because let me tell you there's you know I'm fromor and y'all have 1300 unsheltered homeless folks
across the state of Arkansas I do a lot of work in Los Angeles and everybody likes to say what was that I think so like don't don't let my don't letor or don't let ma Arkansas become California is that what you're saying abouten? but
Senator Missy Irvin
Unverified
31:19
the the thing is it's a great new song called don'tor my Arkansas
Speaker 20
31:23
that's right so I'm not I'm not saying this to but the just in terms of scope Los Angeles County largest one of the largest counties in the country
52000 people unsheltered in Los Angeles County.30,000 with serious mental illness in Los Angeles County. So when I come to a state Wisconsin I went to Wisconsin recently. They point in time count for the number of people that are homeless across the state who were unsheltered510 10 now here's the other thing and and'm I'm gonna get a little policy nerd on you a little bit but bear with me.510 unsheltered
folks across the state of Wisconsin the shelter system in Wisconsin is stronger than the shelter system here in Arkansas the number of individuals with serious mental illness and substance abuse disorder in shelters in Arkansas is 1200 now I'm I'm an advocate I get to go to states and say here's what I think you ought to do so what I told Wisconsin is I think your department of mental healthalth should focus on providing
treatment for500 of the1,200 people that are in shelters that you know have serious mental illness and or addictions. Why? so that you can move those people out of shelters where they're not getting treatment and you can bring those folks that are unsheltered out practically eliminating unsheltered homelessness in Wisconsin and that's the kind of I'm not trying to say you know this is what Arkansas should do necessarily but I'm just simply saying that if you understand the data if you understand the populations and the
subpopulations you can design interventions and you can empower your agencies to meet those metrics and milestones so that you're actually moving the needle and you can begin to lead and you can begin to start you know, moving the needle in terms of how are we doing and let me let me just also lay something aside I I'm not saying that this is going to solve homelessness across the state of Arkansas. What I'm saying is that by being intentional you can begin this iterative process of understanding where money is
going, what they're paying for with respect to interventions and seeing how that's works at the community level and at the community program level and so there you're you're able to actually fine tune and figure out something that has really bedeviled communities and states for these many years and I think going back to some of the reforms that the Trump administration has put out over the past year there's help at the federal level both at hud both at the department of
justice athHs even the department of transportation was identified to begin because there's folks who like can figure out like this isn't county land this isn't state land this is Department of Transportation land. I'm gonna set up camp here anyway enough
Paul Good
Unverified
34:27
of that so thank you so much for that question I hope that I overexplained
Representative R. Scott Richardson
Unverified
34:31
myself and you did and I appreciate that because it gives me a good insight into that and that that kinda my second question around that
you overexplained it now or forgot my question Mr chairir I'll have to come back. I just really forgot no problem just get
back in the queue Representative Ggarner you're recognized for a
Representative Denise Garner
Unverified
34:54
question. Thank you, Mr. Chair and my question too was about the CCHBCs and and I think that those of us who follow the data and know how important the CCBHC model is but I'm not sure everybody does and I want to know what you guys think why is the CCBhC model what we need to be doing
here I mean obviously it's a you know whole whole person system but what else can you tell us a little bit about the CCbhC program and and why that's what is happening nationally and why that's what we need to be doing here. thank you very much for that
Speaker 20
35:32
question I would say real briefly the the reason that the model is so important for Arkansas is because of the same reasons it's so important for other states we know that this is an underserved community we know that the costs of untreated
mental illness and untreated substance use disorder has greater impacts in terms of negative externalities things everything from assaults unintended fires poor outcomes in terms of mortality and morbidity of overdose deaths so it's important to begin to understand how these interventions will begin to start to to change some of those public health outcomes the other important thing about
the CCBhC program because it's focused on behavioral health it it it fills a gap that the current federally qualified health clinics don't address and and and and this is another challenge the the big cha one of the big challenges nationally is we just don't have enough behavioral health practitioners and so how do you feel that well one way you filled it is you incentivize it by creating these prospective payment systems so that you'll be able to attract more mental health more addiction specialists things like that so
it's it's really trying to serve a very underserved and very costly population so that's the short answer follow up Mrir you're
Representative Denise Garner
Unverified
36:59
recognized are we gonna hear from the rest of you guys about your specific programs or otherwise I have a couple of questions I've got a couple of questions one is the data and how we're getting the data and what we do with it after we get it. Paul, you could probably I've
Paul Good
Unverified
37:17
been talking too much I I want I want
Representative Denise Garner
Unverified
37:21
to refer to my colleagues and then also for you ben how do we scale your successes with the rest of the state what what's the best thing that we could do to take what you've done with our house and and implement those programs and the same with our hope same with with Paul crawford the other Paul how how can we do that and what's the best way to do that and the rest of the state. Thank you.
Chair
Unverified
37:51
Yes, so restore hope you know exists to bring communities together on these kinds of complex issues and we've done that around everything from you know foster care incarceration, workforce all all of those things but whenever it comes to homelessness we've of course found in every community that that housing is a major issue amongst the4,500 different families that were served in the last 12 months. over50% of them were either homeless or at risk of homelessness so we're talking
about family homelessness situational homelessness and the and and and mental health was a was a big piece of that as well and in fact it's in the top five needs amongst those that were being served was around mental health and or substance abuse so we are there is a a definitely a better way that we can collect data. I think that in the state of Arkansas you just
HMIs uselo is not transparent enough amongst the providers in order to really work to gather the way that it's intended to work and so continuums of care we all know that that was the intention was to be transparent and to work together and to have these different organizations and sectors that are serving homeless persons to collaborate and help one another and communicate and align their activities
better. So but that doesn't always happen and most if you're if I've been a part of CoC since 2001. Heather and I have been on our our own homeless coalition board for many many years beenn as well and and we're all very clear on the fact that this isn't happening the way it should and that data can be more transparent both not just in a point in time count which we know does not show the
full picture at all of what is going on in our communities and so we would love to to to show how that can happen in a more transparent way and and and we are working right now towards making Hopehub for example meet all of the universal standards data standards for HMIs so that an organization that wants to be more transparent across sectors
with their data would have the ability to do that and still meet all head requirements and and so that is one of the things that we are working very diligently on is making that an option for every community in Arkansas and for every homeless provider and including so many of the faithbased kinds of providers that provide homeless housing but do not use HMIs their data is not included so I think
that once we have a clearer picture we will be able to really show the the state not only you know what those those needs are but also how communities when they work together they do have better outcomes and how when they are transparent with their information and with how they are aligning their activities to better serve these per these families and individuals then then they do
get more services that are needed aligned in the correct order so that they can move to stability and thriving thank you for that umpresentative shepherd you're recognized. Members I
do want to make you aware we have several members in the queue with questions so try to limit that to a couple of questions and then get back in the queue so everyone has an opportunity to get at least a couple of questions in and discuss Representative shepherd thank you Mr chairir and
Representative Tara Shephard
Unverified
42:01
I make my my question quick. so if I
understood correctly you mentioned earlier Paul that 20% of the point in time number were sex offenders I think senator Irving led to that earlier and if so does that represent approximately600 individuals and I think sheriff you mentioned that there's a tracking system in place and if so have we identified what these individuals are located at so thank
Paul Good
Unverified
42:29
you so much for your question Representative Shepherd.
Speaker 20
42:32
My my comment was 20% of unsheltered individuals so
that would be 1213020% what is that about300 and some odd folks. so yeah so and one of the challenges I I just looked the other day at Arkansas's compliance with the sex offender registry notification Act which is federal legislation there are some areas that Arkansas is out of compliance and we've helped other states become more in compliance we've also been introduced in passed legislation in other states that would provide
electronic monitoring for unregistered homeless sex offenders and while this seems like a little bit of a draconian issue. the question isn't you know we're gonna monitor people just because we want to monitor them we're gonna monitor people until they can become compliant with their own sex offender court order that requires them not to be homeless but actually have an address and be compliant with those sex offender recording sex offender reporting requirements that as a part of
their court order so yeah the number's a little bit off but yeah it's for unsheltered and and I use 20% as a general state by state estimate of our because Arkansas's data isn't isn't shared with the department of justice because of those deficiencies in
Paul Good
Unverified
44:01
theirORNA compliance we don't have a specific number for Arkansas do we know which county
Representative Tara Shephard
Unverified
44:09
where they're located it's it's the
Speaker 20
44:14
statewide yeah the statewide I mean and we're we would be happy to work with you to bring Arkansas into compliance with the federal SORNA Act requirements you Senator Hill you're recognized thank you Mr Chair
for allowing the senate to ask a question today. of course Paul this this question's kind of kind of for you. you mentioned a while ago you mentioned California Los Angeles County that's where you were from before that you said is
that your company's from Austin, Texas or that you work
Speaker 20
44:48
with yes sir our headquarters is headquarter Most of our subject matter experts are all over the country. OK are
are you do you actually work in Austin yourself? do not.
Speaker 20
44:57
I live in San Diego and I get the wonderful experience of working out of my home office in San Diego. it's the best job in
the world. I apologize that's a na climate there for sure no doubt my my question is for austin Texas I'm gonna use Austin as an example since that's where your headquarters at. The do y'all work with the city of austin?
Paul Good
Unverified
45:18
sir actually we've been just having conversations so and I'm gonna interrupt
you because that won't go on my question with that because I've actually been to Austin, Texas in they're encampments two years ago were running rapid. and so for me to take this serious with the data that you brought us and things that you want us to do and that's your home headquarters there with the encampments that I've seen there along Interstate35 all up and down through there
what can you do different to improve Arkansas than where we are when I look at austin Texas
Speaker 20
45:56
to see what's being done there. it's it's a fair question thank you so much senator let's just talk a little bit about scope of magnitude the number of unsheltered homeless in Texas is in the 10,000s Texas is a much larger state, a little better population but directly with respect to what we're doing in Austin right now we are working with the city of Austin
to empower and and reform Texas law with respect to things like their CCBhC programs with res and they have they have a much more extensive CCBh program in Texas also with respect to identifying what we would call like high utilizezers people who are serial misdemeanants people who are engaging in law enforcement challenges people who are constantly rotating in and out of emergency departments because of mental health issues so we're trying to bring those together Texas like Arkansas has
a legislature that meets every other year and so we're putting together reforms that would actually focus in and benefit the city of Austin I think one last thing is that Austin has has had some challenges and part of the challenges is they've kind of been whipsawed in terms of you know they used to have a a s a municipal camping ban on homeless encampments and then they got rid of the municipal camping ban and then the citizens actually passed local
ballot proposition to reinstate the camping ban. so there's all kinds of dynamics going on because of you know the policy and the political landscape of Austin but I take your point we're we're working hard we we want to work with whoever is interested in moving the needle on public safety and homelessness and we'd love to share our successes and also some of our failures on what didn't work with you all and with the folks in Arkansas thank you very much
Senator Missy Irvin
Unverified
47:53
thank you ok so just back to the basics sheltered unsheltered homeless what is the difference between the three of us? why you know we we've referred to people as homeless but you have sheltered unsheltered homeless what's the distinction and the difference between the three? as simple as I can
Speaker 28
48:14
make it sheltered means you are in a homeless shelter. you're in a housing program that's been
funded to serve the homeless and the one point that kind of magnifies a little bit with respect to some of these hu changes most of that4.6 million thathud spends on our state each year is goes to what's called permanent supportive housing so that's Hhu funding that is just like it says for homeless people permanent housing so you get a housing unit you can live there forever. So that sounds like sheltered but actually those folks don't count they're not they're considered
permanently housed so they're not homeless anymore. so unsheltered means you're in a homeless program funded to serve the homeless in a in a
Speaker 68
49:02
temporary basis and then unsheltered means you live on a street or another place unfit for human habitation. OK,
Senator Missy Irvin
Unverified
49:09
so unsheltered means no roof over her head whatsoever a tent is unsheltered OK thank you. Representative bennett you're recognized for a question thank
you Mrir. I'd like to do a
Representative Denise Jones Ennett
Unverified
49:25
quick shout out to Ben Goodwin. he runs our house which is in my district and I'm a former board member and I encourage all the members in here if you have time to go and visit our house they're doing some wonderful things there but I do have a question can you elaborate more on holding the providers accountable? are you talking about tie tying the funding to the outcomes can you talk about that?
Speaker 20
49:55
Yes ma'am thank you so much for your question that is one of the alternatives that we've created is kind of like pay for performance and and I'm a really big fan of pay for performance because you could set the criteria however you want. what is your objective? Is your objective one of the things that hud is going to begin to require from the continuums of care and housing providers is we want to see how much increase in earned income individuals that are
in permit support of housing or continuum of care participants are are are seeing and let me just make a quick distinction there's a difference between income because there are a lot of programs out there in fact the federal government funds programs that say how can we get you qualified for snaps for SsI for SsdI for housing all these different programs and and the federal government actually says well those are increases in income but we really want to focus on
increases in earned income to make sure that people are actually able to and accomplish things like they're making more money today than they made last month and that's an important metric so when when you look at like pay for performance I I would love to see and this is a crazy idea I would love to see organizations held accountable for the number of referrals they make for places like CCBhCs or drug treatment centers or things like that versus the number of
people that actually complete the treatment because we know that there is a huge deficit in terms of we're going to refer this person to somebody oh my job is done no no no we're gonna refer this person and then we're gonna make sure to follow case manage that person to make sure that they're actually completing the treatment and we see the outcome so we're I'm a big advocate of pay for performance but here's the other thing so there's a lot of service providers and I I hope I don't step on anybody's toes but there are a lot of service providers that create a lot of
destitution in and around their service provision we know that when you look at the data on homelessness who's receiving services homeless services and you look at the arrest reports and things like that oftentimes you'll see heat maps around service providers why is that if you were at in a university town and there was one fraternity that was constantly throwing their kegs and their sofas and all manner
of stuff all over the place littering it the city would probably have something to say about that and we need to do the same thing to make sure that we're creating public order and so that the people who are coming genuinely to receive services those services aren't being a drag on the community and and so there there are ways that you can do that one thing and I'm just gonna say it umm I speak my mind so I hope y'all don't mind that but how do you regulate public feedings there's one thing to say come
and get a sandwich but there's a whole another thing you say you come and get a sandwich but the longer you leave the trash all over the place the these are not you know you can hold these accountable these providers accountable one of the pieces of legislation that Ciceros introduced in passed in a number of states is what we call drugfree homeless zones we're holding providers accountable for turning a blind eye for drug and other crimes going on under their noses so those are the kinds of things that we're talking about
Speaker 43
53:30
when we're talking about holding providers accountable.
thank you for that Representative Bentley you're recognized for a
Representative Mary Bentley
Unverified
53:39
question thank you chairman thank you all for being here today and I was a little bit late so if I missed this I apologize but so ben or Rusty orarren you guys can do this one we're looking at Arkansas can we apply for a waiver to Arkansas to get all the funds statewide for this continuums of cares is that's something that we can do or is that not? Is it totally federal regulator so can our state say we want this all to be a statewide program so that we can direct these things maybe in a better fashion than they are
Speaker 20
54:09
now. So I, I I I very much appreciate the question because this is a little hobby horse of mine states can compete against the continu of care programs so and if the state puts together an application that receives more points vis a vis the hud continuum of care notice of funding opportunity the state will receive all of the funding so 4 $7 million that looks pretty good to me how
the state would need to fulfill some of the duties of the continu of care. So here and and and I'm a big advocate of this and here's why when continuums of care set out their no fos within the state and then they provide those awards there's very little accountability that goes on. We don't know exactly how the money is actually providing outcomes and some of these continus of care I know this is a case in Louisiana is that when the state auditor
asked the local continuum of care to share data so that they can determine if like snap's benefits and disability benefits and other kind of state provided and administered benefits are being provided to folks in their homeless programs essentially the New Orleans continuing terror told the state to go pound sand well that's a real challenge in terms of accountability and efficiency and making sure that the state so I am a big fan of increasing accountability for federal dollars that are
dispensed in the state by consolidating continuums of care and allowing the state to not only apply but receive these federal continuative care programs there's nothing in the statute or regulation that the federal government that prohibits a state from being considered a statewide continuum of care. Wy om ing big state little population they have a statewide continuum of care. Why? ig state small population but you know then you've got other states like for example Arizona Arizona interesting state re
continuums of care their largesttiative care in terms of square miles the balance of state is administered by the state housing department. The Maricopa County where Phoenix is is administered by Maricopa County association of governments the Tucsons continuum of care is administered by the city of Tucsons essentially you've got three government ent ities that are operating these continuance of care when the the state of arizona could do just as good or better a job and have
greater accountability and greater ability to utilize the state agencies and what the state agencies are used for in order to serve the continuous care and the people that the continued care are are are participating in thank you chairman one quick follow up and thank you for that
Representative Mary Bentley
Unverified
56:59
answer. I appreciate that. So umarren if you can ask this question, I know you did a lot with Resore Hope and 100 families in that so do we have tracking mechanisms now to help folks or not track them anyway bility to get these folks to work so do we have a way to not
only get them treatment but get them to work and to get them self sufficient do we
Chair
Unverified
57:22
have that statewide at this point or what what's your thoughts on that for me? well not statewide and with 100 families yet we're 19 different communities and we'd love for it to be statewide and that's really imperative in order to partner with all of you know workforce with veteran's associations with every other statewide system including child welfare
for example there's so many communities that you know really want to have this ability to partner better but it's not available in their community so that's that's a really important piece and is that once that that is statewide then yes I mean already we've we've integrated and worked well with you know, Robert Mcggo with the chief information officefer and with the launch
and many of those workforce initiatives and and with the 1033 you know pilots as well but yes I think that once we have the the ability to have more of a a statewide network of all of these communities that are you know community by community able to bring together all of the the different
organizations and there in their community to align their activities and to communicate better and to to really solve their own complicated problems and then be able to from community to community know whenever you know a participant for example you know leaves littlettle rock and comes to Fortsmith, then we could you know with these kinds of more transparent systems be able to tell you know we well
why did they leave our house and was it you know and and how can we continue that work with them versus starting all over and that is imperative I think. thank you thank you chairman thank you for that members and
guests I do want to remind you we're closing in on an hour of our conversation we still have a lengthy agenda we want to make sure we get to everyone and get all the questions answered so please be mindful of that with your questions Representative Pilkington you're recognized thank you Mr Chairman's a quick
Representative Aaron Pilkington
Unverified
59:49
question if we were to get this waiver and do CB CCBhCs how many current organizations do you think would qualify to get a certificate within the state
Speaker 24
1:00:01
of Arkansas so today we have had7 CCBhCs within the state of Arkansas and actually all of the outcomes from those CCBHCs were extremely positive just as ours was. but as grant funding ends then teams have to become unfortunately dismantled and so we've lost a lot of that ground
so you would automatically have, I'm not sure how many community mental health centers we have at this time but every community mental healthal center should be eligible to start that process you would also have those others you know, I think I've heard um, someone with an OSam Paula Stone say that there are probably 12 to15 behavioral health agencies who take care of our our adults with serious mental illness. so those in my mind would probably be eligible. Some if they only
treat adults would have to partner and have a direct collaborating organization to partner with so that they could do that together. So statewide we could probably have 12 to13. that that's all I
need. You bet thank you thank you senator Scott,
Senator Jamie Scott
Unverified
1:01:07
you're recognized for a question thank you Mr Chair. thank you all for being here. I have a quick question I think a couple years agopresentative deanne Vaughtult and Representative Keith rooks and I were in a homeless fellowship program for young people we came
back and passed legislation eliminating fees for all state documents for individuals who were aging out a foster care or who were homeless and we've also passed legislation creating a homeless liaison on our college campuses so in a couple of weeks I go back for the fellowship again a continuation of it. I know that I want to focus on legislation probably there's a big population in my district of homeless in individuals in my school district. I recently found out
about like maybe a year ago and I probably want to focus on the young adults that I've been focusing on as well so when I get back who would I need to talk to to bounce off ideas about possible legislation and what that can look like to to keep building on the momentum that we've already kind
Speaker 28
1:02:13
of focused on think we'd probably all love to help but I think including families with children one of the groups you discussed and just to bring them more explicitly in the
conversation I really think that families with children are like if if homelessness is an iceberg the street homeless are the the part you see and then the families are the part you don't see because they are motivated to keep their kids off the street and safe and out of sight but we at our house we serve hundreds of homeless families every year. Another statistic and that I and I can give you the details on it but the your the year of your life
statistically that you're most likely to become homeless is your first year of life. so having a baby is immediately makes you more economically vulnerable it immediately makes your household finances more difficult it makes housing more difficult to maintain and so families with young children families of any age children are particularly vulnerable and I'm excited about hud policy changes that will one of the things Hhu policy has done for years is just almost
pretend homeless families don't exist through the way they define it through the way the point in time count works so I'm excited about some of those changes coming also the to get to uhpresentative garner's question earlier. some of the things that help homeless families aren't necessarily homelessness policy it's child care policy. you know our childcare voucher program has a homelessness waitlist exemption which it's required by federal law to have but is that exemption being you know is it is it as robust as it could be?
I think there's opportunity on the policy side there to really make sure that we help stabilize homeless families with childcare and then employment which has been mentioned several times I mean that is the key to getting most of that se/8 of the iceberg of homelessness out of homelessness is helping them succeed in the workforce and at our house we we do that every day. Last year we helped398 homeless people go out and earn for themselves $11.2 million and so in terms of how do you leverage
money to address homelessness the one of the best ways is tap into the potential and power of people to provide for their own needs and for their own families by helping them succeed in the workforce which takes work it's difficult but it can be done as our and so I would love to be in conversation with you with about families or children in particular on how we how our state can really optimize our policy on that thank you mann thank you for that we have one
more person in the keys representative rose you're recognized for a question.
Thank you Mr. Chairman. thank you to each of you for being here today. I know many of you grateful for your work. it's good to see you here for this discussion and some of this may have been touched on already so if you're having to reiterate, don't bother but I'm just curious as we heard earlier I think you said it's7 states in the country that are not in some way shape or form participating in grant funding through the CCBhC amm my understanding that correctly so whoever would like to take this question I know maybe more
than one of you if the chairman allows the latitude could respond to this but do you know in particular the reasons why our state in like specifically is not participating have you had conversations with DHS are there any just advanced communications that you can share with us to to to shed
Speaker 24
1:05:47
light on that you know we started with our CCBHC back in 2020. So it seems like timing as soon as uh, I think it was the governor Hutchinson and Secretary
Gillespie was on their way out. we were engaging in those conversations so it really had to do with timing because they said well this sounds great we have a new administration getting ready to come in so we really don't want to make changes this time. We, we spoke with Mark White and that was kind of sort of that that discussion at that time and then as we kind of the last go round DHS I mean I think there was just a limited resources and it's like well there will be another one let's kind of push it down the road. I think the problem is we're running out of
time and grant funding you know thank goodness the administration is still currently supporting it so there will be additional CCBhC opportunities for agencies. those are going to be more competitive but we should have a really great shot at the state planning grant at this time. So I think the timing is right. it really hasn't been about timing and being able to make the time and give it the focus it deserves. in my opinion as Mr Chairman it'd be all right to see if anybody else
had any other thoughts they'd like to share I I would just say that it
Speaker 20
1:07:05
in order for the state to take advantage of the CCBHC program. they really need to be intentional and and that's I think that's a challenge I think there's some challenges when you look at all the various I mean y'all you know have a busy committee and you're dealing with a lot of healthcare matters this is a healthcare matter and and I think kind of what we're trying to advocate for the Cicero institute is how do you utilize the CCBhC program so that it
could come alongside some of these very visible challenges that people see everyday in their community with respect to homelessness and that's that's that was never necessarily the the design for the CCBhC program but what we're seeing is as as as states and communities recognize the impacts of untreated serious mental illness addiction they're saying that this is a lever that they can pull so I think there's a little bit of an
evolution of thinking and I also think that that the state really needs to be intentional about how they do this and you know it's a healthcare matter and healthcare is messy
Speaker 24
1:08:16
so yeah and the state is very well positioned at this time I think we know you know, Medicaid tier one there's still a high level of needs if you look at data from Achiii a number of the medicaid tier one people end up in emergency rooms. They still navigate the healthcare system very poorly and so CCBHC really
helps to take care of crisis we're looking for sustainability for our crisis system and the crisis hub right now. So a great deal of areas, I mean that that it covers that our Arkans as priorities those who are coming out of prisons and jails and you know reentry. so there's you know a number of areas that we're we're certainly happy to have a seat at the table and and talk about
Senator Missy Irvin
Unverified
1:08:57
it. yeah and I I just want to follow up. I have not had conversations with DHS specifically about this but as you all know if if a program is 100% federally funded
and then that changes. Gues who it falls on the state and the state agencies and so I can understand hesitation to be frank with you. I mean I really can't and just from a perspective of we've seen that with occa funding we've seen that how many how many different buckets of money that have been cut at the federal level and then guess who gets beat up about it? DHS our state does and it has nothing to do with anything that they did is what happened at the federal level but because they are now the you know, keeper of that fund and
they get blamed and so we that happens repeatedly so I haven't had those conversations but I think that's just a very
Speaker 24
1:09:49
fair statement to say. thank you and if if I may, I think that's very fair as well we've seen you know cuts in federal funding. The, the idea is there are other states have who've been doing it for a while and it's working it's working beautifully so we don't have to reinvent a wheel. we could look at Missouri or others who would say how could we model that and tailor it to our unique needs
and and medicaid ends up taking it but it's a shift and then you do pay for outcomes so it's not that old fee for service model it's just a more common sense you know let's let's make let's let's pay for outcomes. you know we're we're on board thank you
all right well we appreciate you very much for being here. thank you for your presentation. thank you for your time. I know there are probably members of the committee that will be reaching out to you off off camera to have some additional conversations so thank you again for being here. Senator flippo
and welcome that yes sir thank you Senator Flippo you you're recognized for point of personal privilege
Senator Scott Flippo
Unverified
1:10:47
thank you Mr Chairman and members I don't know if everybody saw but I do wanna you know recognize Jamie Barker I see Mr. Barker back there Mr Chairman I know that you played a lot a big role in getting some of today's speakers here to talk about homelessness unsheltered and we understand that certainly that substance abuse mental health play a role in in incarceration and I will address you as Mr chairman as the
chairman of the board of corrections and just want to thank you for your service and your dedication to Arkansas to our communities, to our citizens. I know this position comes oftentimes with a a lot of criticism but sometimes a little gratitude is in order and so on behalf of my colleagues in the legislature and I believe of the citizens of the state of Arkansas thank you sir for your tireless efforts and advocacy for our citizens and their future. thank you. thank you senator flippo
thank you for that right members we're gonna move through the rest of our agenda the rest of the agenda today is rules for review so section D we have someone from the department of Energy who wants to quickly explain your rule if you will identify yourself for the record and you'll
Speaker 105
1:12:09
be recognized to present your rule. amanda Land chief
Speaker 107
1:12:13
counsel Energy andnvironment. Bailey Taylor, chief administrator ofnviron and DEQ
Speaker 105
1:12:16
director. you're recognized thank you Mr Chair. We are here seeking review of the pollution control and ecology commission rules regarding solid waste management specifically found in eight car part60 as it relates to post closure cleanup. The am the proposed amendment would increase the threshold amount for review from50,000 dollars to2 million dollars. this is consistent with a statutory change that happened in 2025
Act791 and so the the adoption of this proposed amendment would make it consistent with that statutory change. thank you for that members
any questions? right we have a question Representative Perry you reckon us for a
Representative Mark Perry
Unverified
1:13:00
question thank you Mr Chairman on the post closure have with the increase on that have any changes been made to the post closure bond that companies are required to have are you
Speaker 107
1:13:12
speaking to the financial assurance when you're permitted no sir,
Speaker 106
1:13:18
not drastically but typical inflation as permits are renewed or changed then we're
Speaker 113
1:13:23
always looking at what's on site what it would cost to close them but not systematically cause the cost has gone exorbitant and some of the
Representative Mark Perry
Unverified
1:13:34
post closure bonds wouldn't cover the cost of that but every time a permit
Speaker 113
1:13:41
is renewed or changed it modified in any way that financial
Speaker 53
1:13:48
assurance is relooked at. OK. right. thank you. bepresentative rose you're recognized
for a question. Thank you Mr Chairman. thank y'all for being with us this afternoon just in short having reviewed the rule the responses says no financial impact or no fiscal impact could you specify any other significant changes that come along with this kind
of the the new ruling from the50,000 dollars limitation to the $2 million limitation like what's what's the significant change
Speaker 113
1:14:19
that's going to go along with that there's really not in practice a significant change because we've been operating under the law since it was enacted and so this just brings the rule into compliance with the law what this means in practice is that each time we need to make an expenditure for post closure care at the state level then we would not need to seek approval from the commission to make that expenditure unless it exceeded $2 million.
Does that does that make things easier for you It does so the commission has repro approved a priority list of post closure of facilities in post closure care and that that need this type of activity remediation and so as long as we're operating off of their priority list that they've approved then we don't see the need in
Speaker 118
1:15:18
duplicative approval for each expend expenditure
so and I think just for due diligence's sake thank you for the latu Mr Chairman. just feel
like I should ask. I'm just looking at some of these comments and some of the questions here about the approval and you know the increase before there is any oversight etc. you don't see any any risk included with having less of a review process and the increase of the the the spend that's allowed without any extra oversight is that is that what I hear the agency saying?
Speaker 106
1:15:57
believe sos our actions are already essentially approved by the commission
Speaker 113
1:16:00
just because they've approved that priority list and so anything that we're doing is trying to protect the human health and the environment with making these remediation efforts on the specific sites and so if something new were to come up, it would automatically exceed that threshold and we would have to go before the commission to receive that approval. right and just to reiterate and I'll be done here the
the consensus here is that the from the fi0,000 to the 2 million is trying to be in line with the Act791 of2025 is that is that what it is the language in that act says 2 million. sir. and we've previously
been operating under the50,000 so that's what this is doing yes sir ok all right thank you thank you
Mr Chairman. thank you for your questions seeing no further questions without objection this rule stands reviewed thank you for being here Section E
if you will please identify yourself for the record who you represent and you'll be recognized to present your rule. would encourage you all to get comfortable. it looks like you have the rest of the
Speaker 127
1:17:26
agenda. Yes thank you good afternoon. I'm Daviddawson general counsel for the board of nursing.
Speaker 129
1:17:34
Hi I'm Ashley Davis I'm the director of the
board of nursing t t mo re al you're recognized to present your rule before you do I do want to congratulate Ashley on your position
Speaker 127
1:17:51
and we're excited to work with you moving forward you're recognized thank you I'll present the information and Doctor Davis and Mr. Gilmore can help me answer any questions that that you may have recognize for section E. Section E is
our rules part 120 the only change in this was to add dialysis patient care technician fees for the initial licenger or registration it's not actually lozener and the dialysis patient care technician registration was created by Act 198 of2025 and we're ready to get up and go with registration but we could not start until we get
the fees approved the requirements of the statute say that you have to have a that the registrant has to pay a fee and the amount of the fee was not designated in the legislation and so the board had to come up with that amount we matched the same amount that we use ford Dallassis I mean for the medication assisted persons which is kind of the lowest level of professions that we certify or license and
but that amount has to be approved byr before it can be implemented so we're just waiting on getting this approved before we can get the program up and going to start registering these individuals and that's in section506 of that subsection506 right members
any questions seeing none without objection this rule stands reviewed Section F. thank
Speaker 127
1:19:32
you. Section F is very simple change we we have a section that requires licensees
to keep their contact information updated but the way it was worded was said that they had to update their address and this is under section 902 and we need more than the address we need the telephone number the email address and if they're residential address is different from their other address we we added that in
great members any questions seeing none without objection this rule stands reviewed Section G thank
Speaker 136
1:20:04
you and sectiong under subsection302 we did the same
Speaker 127
1:20:11
thing with the requirement to keep the contact
information updatedonderful members any questions seeing none without objection this rule stands
Speaker 127
1:20:21
for review. Section F orh thank you is there the one where we made a lot of changes in response to the acts that that allowed delegation to unlicens healthcare professionals but I'll start out at section302
subsection302 was another area where we changed the address requirements to keep the contact information up to date in subdivision 4026 the amendment to the rule under paragraph E for APRN's authority to sign official documents follows the requirement of Act862 of2025 regarding an APRN signing certificates of death and
pronouncements of death other subsection402e9 the purpose was to clarify the orthotics prosthetics or diabetic shoes or inserts that have now been included in the definition of durable medical equipment pursuant to act431 of2025. in subdivision402h this is this is where we
implemented the changes for delegation so I959 of2025 amended Arkansas code 1787107 regarding the delegation of certain nursing tasks to allow APRNs to delegate certain nursing tasks to qualified and trained healthcare worker who is not licensed or otherwise authorized to perform the nursing task these are specific there's specific parameters listed in the legislation which have been
incorporated into this rule all right members any
Representative Jack Ladyman
Unverified
1:22:25
questions Representativeladyman you're recognized thank you Mr Chairman. got a small question I believe but that sub subdivision402C9 when you includes things like diabetic shoes does that make those coverable under like medicaid is that why that change was made do y'all know is that what's the effect of that change
Speaker 141
1:22:48
it's on the front page it was it was an in it was an
Speaker 129
1:22:54
insurance thing where they were not accepting an an APRN's prescription for specifically it was diabetic shoes and inserts so
Chair
Unverified
1:23:01
we just clarified that thank you Senator
Senator Missy Irvin
Unverified
1:23:07
irvin you're recognized I think just general question y'all your rule kept pretty clear like you did your rules keep very close to identical to the legislation thank you
Speaker 144
1:23:22
matter of fact we didn't have very many public comments but one of the public comments
Speaker 127
1:23:29
was asking us to Increase it Yeah, to add we we
Senator Missy Irvin
Unverified
1:23:32
had to say it's not in the legislation we can't do that and that's why I asked the question.
I really appreciate it thank you. thank you senator seeing no further questions without objection this
Speaker 127
1:23:48
rule stands reviewed Section I Under subpart 105 this is also
has to do with actct959 of2025 regarding a delegation of certain nursing tasks the there were exceptions there was a list of nursing tasks here in section 105 that that states that shall not be delegated so we had to put an exception for the ones listed in the statute to say that and except for what's contained in404h of the previous rule you can't do that so
all right thank you for that members any questions? seeing no questions without objection this rule
Speaker 127
1:24:38
stands reviewed Section J. thank you the administrative procedures actct requires that all agencies provide a rule to process for filing considering petitions for declaratory orders and when we were reviewing our rules for changes after last legislative session we realized our rules
didn't include that section so we're we are hopefully gonna be in compliance now and we've included that section I used the the same language that department of healthalth rules used for this for this matter all right
thank you for that members any questions? seeing no questions without
objection this rule stands reviewed. Section K. thank you. this
Speaker 127
1:25:22
section has if you if you see all the changes you'll see that there's there's lots of changes for certified medication assistance there
there are some substantive changes that have to do with the training and the and also some think it's some injections that that these individuals can do now but part of the act Act265 of2025 also changed the title from medicationsisted certified to certified medication assistance there's another commonly commonly used title for another healthcare worker in Arkansas
called certified Medication Assistant that uses the same acronym CMA and so we had lots of stakeholders that said we're worried about that causing confusion the the legislation though did allow the people who are certified to use either title CMA or MAC and because of that we thought we could use both we could put both of the titles in our rules and so you'll see all the way through the rules it's just kind of adding in the the
the title CMA also I will tell you about the the sections that do have specific sections 1021A and B to the previous requirements for certification and qualifications were removed and that's pursuant to the act Act265 of2025 and the training course hours have been increased to not less than 115 hours and that's also requirement of the legislation under sub
division 1021b 2265 now allows certified individuals to administer subcutaneous insulin injections after additional training and that that's section is where those provisions have been implemented so division's 105b8 also adds subcutaneous insulin and subcutaneous injections of insulin to the list of routes in which nonprescription and alleging medications may be administered and that's also
added by Act265 subdivision 105C2 there once again there was also a list of here saying that there were certain things that that they they were not allowed to do so we had to accept this injectable medications that act 265 are now allows section 109 previous to previously the rule required that certified MACs update their address oh this is this is matching the the update the address information that we've done in their other areas
and I think the well we've got a couple more 110A2 we changed the timeline here for mailing renewal notices from30 days to60 days because we noticed that other professionals we allow60 days and so we wanted to make this consistent with everyone else subdivision 113C6 revised the training requirements for certification and added the task of subcutaneous injection
insulin injections as allowable tasks so this kind of gives more information about the actual education requirements that Act265 required and then the last one is subdivision 113d2A We consult after consulting with the institutions that provide MAC training the overall rates for or
for the first the pass rate requirements were changed from first time percentage to overall percentage they ask us to do that because it it gives them a better chance of being successful and the outcomes in the long run are not going to be any different it's not gonna be we don't think it's gonna be a detriment to allow them to have to use that overall percentage as opposed to a first time percentage perfect thank you for that explanation members any
questions? seeing none without objection this rule stands
Speaker 127
1:29:53
reviewed Section L. Thank you Section L is changes to the Full independent practice credentialing committee rules and act 872 of235 this is in for the whole thing expanded full independent practice to clinical nurse specialist and the subsequent amendment to the board's rules regarding full independent practice,
credentialing committee was inadvertently left off in 2023 0 it was going so this is in to comply with actct872 of2023 and so we realized it was inadvertently left off so this change was made to add clinical nurse specialists among the nurse practitioners who can apply for independent practice in subdivision 201 A5A2B3
act 872 of2023 also expanded to clinical nurse specialists and so we just changed the title in here this was in response to some public comments that both titles now may now apply for independent practice the term nurse practitioners is replaced with the term applicant and additionally the word nurse has been removed to use the term practitioners because it practitioners cover both titlesue Senator yeah and both
Senator Missy Irvin
Unverified
1:31:18
of them have the same degree, is that correct? It was
just an in averse so that's why we didn't have to pass legislation is that
Speaker 129
1:31:27
correct that is correct and that their degrees are are similar but it was passed in legislation in 2023 ok and we're just getting our rules in in compliance that's what I understood that's why we
Senator Missy Irvin
Unverified
1:31:37
didn't have to because we had that discussion back during session do we have to create a new law and pass additional legislation but I think that we determined that we didn't have to and we were able to do it by rule thank you
members any other questions seeing none without objection this rule stands reviewed. Sectionm thank you
Speaker 127
1:32:01
this is this has to do with uhd Dallas's patient care technicians this is the the this is actually the new section that we implemented in response to Act 198 of2025 and these rules were patterned after the board's rules for medication assistance certified
individuals because that's the profession iss most closely aligns with the the new uhd Dallassis patient care technician registration there are section 114 was put in to clarify that the act and rules do not apply to dialysis patient care technicians working directly with a physician that was part of the statute
The Bureau of Legislative Research was very helpful in helping us make sure we we had it formatted correctly because it's a whole new
section well they're amazing we're proud to hear that Members any questions seeing none without objection this rule stands reviewed. thank you for being here today. I think that concludes your business all right you're dismissed from the table. thank you any additional business by the committee seeing none senator Ivi anything you'd like to mention before we close?
Senator Missy Irvin
Unverified
1:33:27
thank you one thing that I just wanted to tell this committee because this legislature works so hard on this and I'm just so appreciative to Lory barnes our chancellor of UAMS. Our NCI designation submission was completed yesterday that is a huge big deal it's obviously the first step in a very long process but the fact that we have come thus far and we have put so much efforts and
resources this legislature worked really hard with UAMs and the UAMSboardard of board of trustees and the foundation members of the NCI or of the WinthropRockefeller Cancer Institute. I just can't say enough about all of them and their hard work. they just so this is just incredible so so glad we're here so I think that's just something I just wanted to announce and be proud to be able to say great job here we go let's do it and
keep our fingers crossed that our application is complete and accepted. Well that's exciting news
for the state of Arkansas thank you for that right members seeing no further business we stand adjourned
Agenda
A. Call to Order
B. Consideration to Approve the April 1, 2026, Meeting Minutes [Exhibit B]
C. Discussion of Homeless Policies, Trends and Opportunities for Arkansas to Lead [Exhibit C]
D. Department of Energy and Environment (E&E), Division of Environmental Quality (DEQ), Review of Rule, 8 CAR pt. 60 “Solid Waste Management Rules” [Exhibit D]
E. Arkansas Department of Health (ADH), Division of Health Related Boards, Arkansas State Board of Nursing (ASBN), Review of Rule, 17 CAR pt. 120. General Provisions [Exhibit E]
F. ADH, Division of Health Related Boards, ASBN, Review of Rule, 17 CAR pt. 121. Licensure: Registered Nurse, Licensed Practical Nurse, and Licensed Psychiatric Technician Nurse [Exhibit F]
G. ADH, Division of Health Related Boards, ASBN, Review of Rule, 17 CAR pt. 122. Registered Nurse Practitioner [Exhibit G]
H. ADH, Division of Health Related Boards, ASBN, Review of Rule, 17 CAR pt. 123. Advanced Practice Registered Nurse [Exhibit H]
I. ADH, Division of Health Related Boards, ASBN, Review of Rule, 17 CAR pt. 124. Delegation [Exhibit I]
J. ADH, Division of Health Related Boards, ASBN, Review of Rule, 17 CAR pt. 126. Rules of Procedure [Exhibit J]
K. ADH, Division of Health Related Boards, ASBN, Review of Rule, 17 CAR pt. 127. Medication Assistant- Certified [Exhibit K]
L. ADH, Division of Health Related Boards, ASBN, Review of Rule, 17 CAR pt. 130. Full Independent Practice Credentialing Committee [Exhibit L]
M. ADH, Division of Health Related Boards, ASBN, Review of Rule, 17 CAR pt. 131. Dialysis Patient Care Technicians [Exhibit M]
N. Other Business
O. Adjournment
Documents
No documents posted.
Speakers
Representative Jeremy Wooldridge Chair
Unverified
Senator Missy Irvin
Unverified
Danny Baker
Unverified
Speaker 17
Speaker 20
Speaker 22
Speaker 24
Chair
Unverified
Speaker 28
Speaker 31
Paul Good
Unverified
Representative R. Scott Richardson
Unverified
Representative Denise Garner
Unverified
Representative Tara Shephard
Unverified
Senator Ricky Hill Chair
Unverified
Speaker 68
Representative Denise Jones Ennett
Unverified
Speaker 43
Representative Mary Bentley
Unverified
Representative Aaron Pilkington
Unverified
Senator Jamie Scott
Unverified
Representative Ryan A. Rose Chair
Unverified
Senator Scott Flippo
Unverified
Speaker 105
Speaker 107
Representative Mark Perry
Unverified
Speaker 106
Speaker 113
Speaker 53
Speaker 118
Speaker 127
Speaker 129
Speaker 136
Representative Jack Ladyman
Unverified
Speaker 141
Speaker 144