Public Health, Welfare and Labor Committee - Joint
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of the April 1st minutes. I have a motion. Do we have a second? Second. All those in favor say aye. Aye. Opposed? 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 presentation. Members, I think you have a handout, and it's also obviously going to be on the screen. Thank you.
Senator Missy Irvin
Unverified
2:30
thank you Mr. Chair I appreciate everybody coming today I'm excited about having this discussion that we have on the agenda coming up next I want to say if you attended our meetings down in Texarkana and I believe Arkadelphia right in that Kate where we went Arkadelphia yeah 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 crisis 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 72-hour 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 health care 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 complicated discussion so if I'm excited to have everybody here to really have this discussion thank you mr. chair
thank you to the co-chair 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
Danny Baker
Unverified
4:24
your presentation Good afternoon. My name is Danny Baker. I'm the police chief in the city of Fort Smith. I appreciate the opportunity to be here today and be part of this
Speaker 17
4:35
discussion. Thank you. Hi, I'm Heather Webb. I am with Arkansas Family Alliance and the former director and still consultant for Community Rescue Mission, a family homeless shelter in Fort Smith.
Speaker 20
4:45
Good afternoon. My name is Paul Webster. I'm a senior fellow with the Cicero Institute and advocacy
Speaker 22
4:51
and public policy organization out of Austin,
Speaker 24
4:56
Texas. Good afternoon. My name is Rusty Hallwick and I'm the CEO of Western Arkansas Counseling and Guidance Center. We're a community mental health center and a grant-funded certified community behavioral health clinic. We cover six counties in the most western part of the state. Thank you.
Chair
Unverified
5:14
I'm Karen Phillips and I work for
Restore Hope. I'm the Chief Operations Officer for Restore Hope and Restore Hope Housing, and we currently serve 19 different communities in Arkansas. Hi, I'm Ben Goodwin. I'm the Executive
Speaker 28
5:29
Director of Our House, a program here in Little Rock that serves homeless families and individuals and helps hundreds of homeless people find jobs and achieve stability each year. Well, thank you all for being
here, and you're recognized to present.
Speaker 31
5:45
Thank you so much. Uh, I appreciate the opportunity to address the
Speaker 20
5:50
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 and discussion with them because they all represent different facets of the response to homelessness and different programs that are doing great work
to deal with this issue um let me see there we go uh 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 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 is that the wrong help for many people 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 has five 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 assistant
funding. One of the challenges of the current system has been that COCs have promoted solutions determined by experts from Washington, D.C., 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 and 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 a 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 of 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 substance use disorders the 20-year data of funding and results are a mixed bag in arkansas cocs have received around four million dollars a year for the last 15 years and homelessness after initial decline has stayed about the same with around 2 500 homeless statewide 1200 unsheltered
and 600 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 2005 doesn't necessarily work the same way in 2026. Other states like Utah are focused more on treating addictions and untreated mental illness than the provision of housing and they're doing reforms that are very interesting to address the challenges because as you could see here unless we
do something different you're basically going to 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 has not reduced the number of people that are living and dying on the streets in communities all across the country and here as well in Arkansas. So why is this? Well, one of the reasons is the state of homelessness. These graphs are from a 2019 study of the largest number of unsheltered people surveyed in the
country, 64,000 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 can see that about 78% and 75% respectively of folks that are unsheltered have some kind of mental illness or some kind of substance use disorder. And I really want to focus in on the disparity between the number of folks who are in shelter who have a substance use disorder at 13%
and the number of folks that have a substance use disorder that are unsheltered at 75%. What does that tell you? Well, what 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 it's clear that these systems addressing mental illness and addiction oftentimes fail and are producing the kind of street-level destitution and disorder that garners press headlines,
impacts public safety, and results in serious public health outcomes. So 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 really 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 communities 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 about $4.6 million 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 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 continuous care to reduce regulatory and resource barriers, improve 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 leave it at that, and maybe we can talk a little bit more about it 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 crime and civil disorder empowers 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 for the homeless and communities. And I really want to focus in in detail 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 2024 data, there are about 28 folks that are homeless across the entire state. Of that 2,800, about half or 1,300 are unsheltered that are living in the woods, they're living
on streets, they're living in parks. Out of that unsheltered, about 42% 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 provides 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 are doing is what the state is technically is potentially paying them to do. Better monitoring and identification of homeless sex offenders,
which make up nationally about 20 percent of the unsheltered homeless population and diversion for unsheltered individuals with outstanding warrants will impact a majority of the 1,300 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 Certified Community Behavioral Health Clinic program statewide by submitting a planning grant to the federal government through SAMHSA. Another one is collect better data and require communities to collect better data and report better data. Require improvements in self-sufficiency 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. Reform 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 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 than 3,000 homeless people in the state. Targeted, data-driven innovations can reduce street suffering, improve public and behavioral health and impacts to communities. The White House has created a pathway to addressing many of the most visible and challenging issues. 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 here for 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 Ervin.
Senator Missy Irvin
Unverified
21:06
Thank you. I'm just curious 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 do have an Arkansas Sex Offender Managers 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 really are frontline interactive with any and all sex offenders that are basically living in the public and outside of the corrections. Have y'all had any interactions or discussions with them? Yes, ma'am, we
Danny Baker
Unverified
21:46
have at Fort Smith. And 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 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 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
22:21
know we have lots of questions.
Thank you. Keep having those conversations. This is a great group of people. Thank you, Madam
Chair. I have a question for you, and we've got several members in the queue. 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 Human Services to take advantage of that
and bring those dollars into the state of Arkansas. But can you tell us, in your words and opinion, what
Paul Good
Unverified
23:06
that would do for the state of Arkansas? Certainly. And I'm going to speak very briefly.
Speaker 20
23:12
And then I'd really like Rusty, who actually administers the CCBHC program through SAMHSA, 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 Medicaid
covered services under the prospective payment system. So instead of relying on the very weak reimbursement of medicaid reimbursement for specific uh you know health conditions uh ccbhcs are intended to assist the communities because we know that there are a lack of uh public state hospital beds for folks that are seriously mentally ill we also know that there are challenges with respect to uh 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 jail-based treatment. Other examples are how do we integrate treatment with housing programs so that we make sure that folks aren't getting evicted because of a mental illness or a 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 with respect to their housing stability. So I'm going to stop there and allow Rusty to talk a little more about that. Thank you so much,
Speaker 24
25:06
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 costs.
And some of the behavioral health agencies or the CSSPs, community support service providers, already licensed 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 2020, we were awarded.
It was during the height of the pandemic, and the Trump administration at that time was pushing out these federal grants. And so we were awarded a federal SAMHSA 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-day access, there's 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 evidence-based model, and it uses, basically, it's assertive community treatment. So you have a multidisciplinary team of people. It goes from your psychiatric medical providers. You have a licensed mental health professional, a substance abuse provider, a peer support person. People with lived experience 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 Health Treatment Court. And the courts 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 perfect formula, you know, for outcomes. And our outcomes have really been tremendous. So we have shown, pardon my voice, we have shown, I think, a 79% reduction in homelessness in these people.
70% reduction in time spent in hospitals, 58% reduction in ER visits, and 61% of time of persons spent in treatment facilities. Those are all very high costs otherwise spent, and 84% less time in correctional facilities and arrests, so very effective. I mean, if I
Speaker 20
27:47
could be so bold, I would very much encourage the state of Arkansas to apply for that SAMHSA grant. And, in fact, I know that there are about five individual CCBHC clinics that are being funded through SAMHSA.
But, you know, Rusty's program has been so effective and has such good outcomes. My recommendation is take a look at her application and just, you know, say this is what we want to do at a 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. 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 let me see if i can
Representative R. Scott Richardson
Unverified
28:59
recognize you here thank you mr chair and and thank you guys for being here um you guys are doing fantastic work uh and one of my questions were already asked
and and the chair kind of dug into that with the ccbhcs i guess my questions are more for you paul right now from a large perspective, in the work that you've done around the country and other states, where does Arkansas rank in terms of homelessness and improvements that we're making or
Speaker 31
29:32
not making? Thank you so much, Representative, for that question. And I want to caveat
Speaker 20
29:38
it a couple of different ways on the one hand uh arkansas receives the smallest amount of awards
per capita of homeless folks 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 top right 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, is actually kind
of holding steady. So when you look at the amount of money and when you look at the point in time counts, 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 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 from California,
and you all have 1,300 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, say, like, don't let my Arkansas become California. Is that what you're talking about, Senator? But the thing
Senator Missy Irvin
Unverified
31:14
is. It's a great new song called Don't California My
Speaker 20
31:18
Arkansas. That's right. So I'm not saying this to, but just in terms of scope, Los Angeles County,
one of the largest counties in the country, 52,000 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, their point in time count for the number of people that are homeless across the state who were unsheltered, 510, 510. Now, here's the other thing, and I'm going to 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 1,200. Now, 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 Health should focus on providing treatment for 500 of the 1,200 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 moving the needle in terms of how are we doing. And let me just also lay something aside. 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 works at the community level and at the community program level.
And so there 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, at HHS, even the Department of Transportation was identified to begin, because there's folks who can figure out, like, this isn't county land, this isn't state land, this is Department of Transportation land.
I'm going to set up camp here. Anyway,
Paul Good
Unverified
34:22
enough of that. So thank you so much for that question. i hope that i
Representative R. Scott Richardson
Unverified
34:26
over explained myself well and you did and i appreciate that because that gives me a good insight into that uh and that that kind of my second question around that um you over explained it now i forgot my question uh uh mr chair i'll have to come back i just really forgot no problem
just get back in the queue representative garner you're recognized for
Representative Denise Garner
Unverified
34:49
a question. Thank you, Mr. Chair. And my question too was about the CCHBCs. And I think that those
of us who follow the data 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 whole person system, but what else can you tell us a little bit about the CCHBHC program and and why that's what is happening nationally and why
Speaker 20
35:25
that's what we need to be doing here yeah thank you very much for that question I would say real briefly that 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 on 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 change some of those public health outcomes the other important thing about the CCBHC program because it's focused on behavioral health it it fills a gap that the current federally qualified health clinics don't address and and and and this is another challenge so that the big chat one of the big challenges nationally is we just don't have enough behavioral health practitioners and so how do you fill
that well one way you filled 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 mr. chair you're recognized are we going to
Representative Denise Garner
Unverified
36:54
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
Paul Good
Unverified
37:12
probably I've been talking too much I want I want to refer to my colleagues
Representative Denise Garner
Unverified
37:17
yep and then also for you Ben how do we scale your successes with the rest of the state 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 can we do that and what's the best way to do that and the rest of the state thank you
Chair
Unverified
37:48
know exists to bring communities together on these kinds of complex issues and we've done that around um everything from you know foster care incarceration workforce all of those things. But whenever it comes to homelessness, we've of course found in every community that housing is a major issue. Amongst the 4,500 different families that were served in
the last 12 months, over 50% of them were either homeless or at risk of homelessness. So we're talking about family homelessness, situational homelessness, and mental health was a big piece of that as well. 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 definitely a better way that we can collect data. I think that in the state of Arkansas, just HMIS use alone
is not transparent enough amongst the providers in order to really work together the way that it's intended to work. And so Continuums of Care, we all know that 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, I've been a part of COCs since 2001. Heather and I have been on our own homeless coalition board for many, many years, been as well. 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 show how that can happen in a more transparent way. And we are working right now towards making Hope Hub, 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 HUD requirements.
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 faith-based 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 state not only, you know, what 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 families and individuals, 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. Representative Shepard, you're recognized. As 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
Representative Tara Shephard
Unverified
41:56
a couple of questions in and discuss. Representative Shepard. Thank you, Mr. Chair, and I'll make 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 approximately 600 individuals?
And I think, Sheriff, you mentioned that there's a tracking system in place. And if so, have we
Paul Good
Unverified
42:24
identified where these individuals are located at? So thank
Speaker 20
42:27
you so much for your question, Representative Shepard. My comment was 20% of unsheltered individuals. So that would be 1,300, 20%. What is that, about 300 and some odd folks? So, yeah. And one of the challenges, 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 and 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 going to monitor people just because we want to monitor them. We're going to 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 reporting requirements as a part of their court order. So, yeah, the number's a little bit off, but, yeah, it's for unsheltered. And I use 20% as a general state-by-state estimate. Because Arkansas' data isn't shared with the Department of Justice because of those deficiencies
Paul Good
Unverified
43:56
in their SORNA compliance,
we don't have a specific number for Arkansas.
Representative Tara Shephard
Unverified
44:04
Do we know which county, where they're
Speaker 20
44:07
located? No, it's statewide. Yeah, the statewide. I mean, and we would be happy to work with you to bring Arkansas into compliance with the federal SORNA Act requirements. Thank you. Senator Hill, you're recognized. Thank
you, Mr. Chair, for allowing the Senate to ask a question today. Of course.
Paul, this question is 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 it your company is from Austin, Texas, that you work with? Yes, sir. Our
Speaker 20
44:43
headquarters is in Austin. Your headquarters is, okay. Most of our subject matter experts are all over the country. Okay.
Do you actually work in Austin yourself? I do not. I
Speaker 20
44:52
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 nice climate there for sure, no doubt.
My question is for Austin, Texas. I'm going to use Austin as an example since that's where your headquarters is at. Do y'all work with the
Paul Good
Unverified
45:12
city of Austin? Yes, sir. Actually, we've been just having conversations. So I'm going to
interrupt you because I'm going to my question with that because I've actually been to Austin, Texas, and their 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 Interstate 35, all up and down through there, what can you do different to improve Arkansas than where we are when I look at
Speaker 20
45:51
Austin, Texas, to see what's being done there? 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 reform Texas law with respect to things like their CCBHC programs.
And they have a much more extensive CCBH program in Texas, also with respect to identifying what we would call like high utilizers, people who are serial misdemeanors, 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 and and benefit the
city of austin i think uh one last thing is that austin has has had some challenges uh and part of the challenges is they've kind of been whipsawed in terms of you know they used to have a municipal camping ban on homeless encampments and then they got rid of the municipal camping ban and then the citizens actually passed a 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
Senator Missy Irvin
Unverified
47:47
very much. Thank you. Senator Durbin. Sorry,
thank you. Okay, so just back to the basics, sheltered, unsheltered, homeless. What is the difference between the three of those?
Why, you know, we refer to people as homeless, but you have sheltered, unsheltered, homeless. What's the distinction and the difference between the three? As
Speaker 28
48:09
simple as I can 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 HUD changes, most of that $4.6 million that HUD spends on our state each year goes to what's called permanent supportive housing.
So that's HUD 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 considered permanently housed, so they're not homeless anymore. So unsheltered means you're in a program funded to serve the homeless in a temporary basis.
Speaker 68
48:57
And then unsheltered means you live on a street or another place unfit for human habitation. Okay,
Senator Missy Irvin
Unverified
49:04
so unsheltered means no roof over our head whatsoever.
A tent is unsheltered. Correct. Okay, thank you. Representative Bennett,
you're recognized for a question. Thank
Representative Denise Jones Ennett
Unverified
49:17
you, Mr. Chair. I'd like to do a 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 um can you elaborate more on
holding the providers accountable are you talking about tying tying the funding to the outcomes can you talk about that yes ma'am thank you so much for your
Speaker 20
49:50
question that is one of the uh alternatives that we've created is kind of like pay for performance uh 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 continuance of
care and housing providers is we want to see how much increase in earned income individuals that are in permanent supportive housing or continuum of care participants 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 uh qualified for snaps for uh ssi for ssdi um 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 you look at like pay for performance, 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 going to refer this person and then we're going to 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 uh there's a lot of service providers and 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 uh we know that when you look at the data on homelessness who's receiving services homeless services and you look at the um uh 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 beginning a drag on the community, and so there are ways that you can do that. One thing, and I'm just going to say it, I speak my mind, so I hope you all don't mind that, but how you regulate public feedings. There's one thing to say, come and get a sandwich, but there's a whole other thing, and you say, you come and get a sandwich, but then you leave the
trash all over the place. These are not, you know, you can hold these accountable, these providers accountable. One of the pieces of legislation that Cicero has introduced and passed in a number of states is what we call drug-free 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 when we're talking about holding providers
Speaker 43
53:25
accountable. Thank you for that. Representative Bentley, you're
Representative Mary Bentley
Unverified
53:32
recognized for a 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 um so Ben or rusty or Karen you guys can do this when we're looking at Arkansas can we apply for a waiver to Arkansas to get all the funds statewide for this continues of care is that something that we can do or is that not it's a totally federally regulated 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 now so I I very
Speaker 20
54:04
much appreciate the question because this is a little hobby horse of mine states can compete against the continuum 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 dollars that looks pretty good to me however
the state would need to fulfill some of the duties of the continuum of care. And I'm a big advocate of this, and here's why. When Continuums of Care set out their NOFOs 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 Continuums of Care, I know this is a case in Louisiana,
is that when the state auditor asks the local continuum of care to share data so that they can determine if, like, SNAPS benefits and disability benefits and other kind of state-provided and administered benefits are being provided to folks in their homeless program, essentially the New Orleans continuum of care 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 continuum of care programs.
There's nothing in the statute of regulation of the federal government that prohibits a state from being considered a statewide continuum of care. Wyoming, big state, little population, they have a statewide continuum of care. Why? Big state, small population. But, you know, then you've got other states like, for example, Arizona. Arizona, interesting state. Three continuums of care, their largest continuum of 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 Tucson continuum of care is administered by the city of Tucson. Essentially, you've got three government entities that are operating these Continuums of Care when 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 Continuums of Care
and the people that the Continuums of Care are participating in. Thank you, Chairman.
Representative Mary Bentley
Unverified
56:54
One quick follow-up, and thank you for that answer. I appreciate that. So, Karen, if you can ask this question, I know you do a lot with Restore Hope and 100 Families and that, so do we have tracking mechanisms now to help folks, or not tracking, but anyway, ability 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 have that
Chair
Unverified
57:17
statewide at this point, or what's your thoughts on that for me? Well, not statewide 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 veterans 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 a really important piece, and is that once that is statewide, then yes, I mean, already we've integrated and worked well with, you know, Robert Magoo with the chief information officer and with LAUNCH and many of those workforce initiatives and with the 1033, you know, pilots as well.
But, yes, I think that once we have the ability to have more of a statewide network of all of these communities that are, you know, community by community, able to bring together all of the different organizations in their community to align their activities and to communicate better and to really solve their own complicated problems.
problems, and then be able to, from community to community, know whenever, you know, a participant, for example, you know, leaves Little Rock and comes to Fort Smith, then we could, you know, with these kinds of more transparent systems, be able to tell, you know, 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
Representative Aaron Pilkington
Unverified
59:42
questions representative he'll continue recognized thank Thank you, Mr. Chair. Mine's a quick question. If we were to get this waiver and do CCBHCs, how many current organizations do you think would qualify to get a certificate within the state of
Speaker 24
59:54
Arkansas? So today we've had seven CCBHCs within the state of Arkansas and actually all 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 health center should be eligible to start that process you would also
have those others you know I think I've heard someone within OSAM Paula Stone say that there are probably 12 to 15 behavioral health agencies who take care of 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 to 13. okay that that's all i need you bet
thank you thank you senator scott you're
Senator Jamie Scott
Unverified
1:01:02
recognized for a question thank you mr chair um thank y'all for being here i have a quick question um i think a couple years ago representative deanne Vaught and Representative Key Brooks 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 of foster care or who were homeless. And we've also passed legislation creating a
homeless liaison on our college campuses. So in a couple 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 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
1:02:08
of focused on 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 homelessness is an iceberg the street homeless are 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 um 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 um 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 with any age children, are particularly vulnerable. And I'm excited about HUD policy changes that will, one of the things HUD 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, to get to Representative Garner's question earlier, some of the things that help homeless families
aren't necessarily homelessness policy, it's childcare policy. 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 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 7/8 of the iceberg of homelessness out of homelessness is helping
them succeed in the workforce. And at our house, we do that every day. Last year, we helped 398 homeless people go out and earn for themselves $11.2 million. And so in terms of how do you leverage money to address homelessness, one of the best ways is to 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 with children in
particular on how how our state can really optimize our policy on that thank
you man thank you for that we have one more person in the queue 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's seven states in the
country that are not in some way, shape, or form participating in grant funding through the CCBHC. Am I 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, uh, 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, um, just advanced communications that you can share with us to, to, to shed light
Speaker 24
1:05:42
on that? So, 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 Gary 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 spoke with Mark White, and that was kind of some of 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 has been about timing and being able to make the time and give it the focus it deserves, in my opinion.
Mr. Chairman, it would be all right to see if anybody
Speaker 20
1:06:59
else had any other thoughts they'd like to share. I would just say that in order for the state to take advantage of the CCBHC program, they really need to be intentional. And I think that's a challenge. I think there's some challenges when you look at all the various – I mean, you all have a busy committee and you're dealing with a lot of health care matters. This is a health care matter. And I think kind of what we're trying to advocate for at the Cicero Institute is how do you utilize the CCBHC program so that it can come alongside some of these very visible challenges that people see every day in their community with respect to homelessness.
And that was never necessarily the design for the CCBHC program, but what we're seeing is 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 the state really needs to be intentional about how they do this.
And, you know, it's a health care matter, and health care
Speaker 24
1:08:11
is messy. Yeah, and the state is very well positioned at this time. I think we know, you know, Medicaid Tier 1, there's still a high level of needs. If you look at data from ACI, a number of the Medicaid Tier 1 people end up in emergency rooms. They still navigate the health care 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 it covers that are Arkansas 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 certainly happy to have a seat at the
Senator Missy Irvin
Unverified
1:08:52
table and talk about it. Yeah, and 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, guess 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. And just from a perspective of, we've seen that with VOCA 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 that happens repeatedly.
So I haven't had those conversations, but I think that's just a very fair statement to say.
Speaker 24
1:09:43
Thank you. And if I may, I think that's very fair as well. We've seen, you know, cuts in federal funding. The idea is there are other states who have 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 we say, how could we model that and tailor it to our unique needs? 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 pay for outcomes.
You know, 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 camera to have some additional conversations. So thank you again for being here. Senator Filippo? Thank you, and I welcome that. Yes, sir. Thank you. Senator Filippo, you're recognized for a point of personal privilege. Yeah, thank you,
Senator Scott Flippo
Unverified
1:10:42
Mr. Chairman. And members, I don't know if everybody saw, but I do want to, you know, recognize Jamie Barker.
see Mr. Barker back there. Mr. Chairman, I know that you played 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 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 lot of criticism, but sometimes a little
gratitude is in order. And so on behalf of my colleagues in 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. Thanks, Senator Flippo. Thank you
for that. All right, members, we're going to 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 be recognized
Speaker 107
1:12:08
Chief Counsel, Energy and Environment. Bailey Taylor, Chief
Speaker 105
1:12:11
Administrator of Environment and DEQ 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 8-CAR Part 60 as it relates to post-closure cleanup. The proposed amendment would increase the threshold amount for review from $50,000 to
$2 million. This is consistent with a statutory change that happened in 2025, Act 791. And so the adoption of this proposed amendment would make it consistent with that statutory change. Thank you for that. Members, any questions? All right.
We have a question. Representative Perry, you're recognized for a question.
Representative Mark Perry
Unverified
1:12:55
Thank you, Mr. Chairman. On the post-closure, with the increase on that, have any changes been made to the post-closure bond that companies are required to have?
Speaker 107
1:13:07
Are you speaking to the financial assurance when
Speaker 106
1:13:12
you're permitted? Right. No, sir, not drastically, but typical inflation. As permits are renewed or changed,
Speaker 113
1:13:18
then we're always looking at what's on site, what it would cost to close. them but not uh systematically yeah because i know the cost has gone
Representative Mark Perry
Unverified
1:13:29
exorbitant and some of the post-closure bonds wouldn't cover the cost of that right but
Speaker 113
1:13:36
every time a permit is renewed or
changed modified in any way that financial assurance is re-looked at okay all
Speaker 53
1:13:46
right thank you representative rose you're recognized for a question thank you mr
chairman thank you all for being with us this afternoon uh just in short uh having reviewed the rule the responses it says no financial impact or no fiscal impact could you specify any other significant changes that come along with this uh kind of the the
new ruling from the fifty thousand dollar limitation
to the two million dollar limitation like what's what's the significant change that's going to go along with
Speaker 113
1:14:16
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 two million dollars
does that does that make
Speaker 113
1:14:50
things easier for you it does so the commission has approved 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 duplicative
Speaker 118
1:15:15
approval for each expenditure expenditure so and i
think just for due diligence sake thank you for the line to mr chairman um i
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, et cetera, you don't see any risk included with having less of a review process and the increase of the spend that's allowed without any extra oversight.
Speaker 106
1:15:47
Is that what I hear the agency saying? Yes, I believe so. Our actions are already essentially
Speaker 113
1:15:55
approved by the commission just because they've approved the 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 these 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 all right
Speaker 121
1:16:18
just to reiterate and i'll be done here the
the consensus here is that the from the 50 000 to the 2 million is trying to be in line with the act 791 of 2025 is that is that what it is the language in that act says 2 million yes sir and
we've previously been operating under the 50 000 so that's what this is doing yes sir okay all right thank
you thank you mr chairman thank you for your questions uh 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 I would encourage you all to get comfortable it looks like you have the rest of
Speaker 127
1:17:21
the agenda yes thank you good afternoon I'm David Dawson general counsel for the board of
Speaker 129
1:17:26
nursing hi I'm Ashley Davis I'm the director
of the board of nursing Matt Gilmore department health you're recognized present your rule before you do I do want to congratulate Ashley on
Speaker 127
1:17:46
your position and we're excited to work with you moving forward you're recognized thank you I'll present the information and Dr. Davis and Mr. Gilmore can help me answer any questions that you may have. All right. You're recognized for Section E. Section E is our rules part 120 and the only change in this
was to add dialysis patient care technician fees for the initial licensure or registration. It's not actually licensure and the dialysis patient care technician registration was created by act 198 of 2025 and we're ready to get up and going 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 for dialysis 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 by rule before it can be implemented so we're just waiting on getting this approved before we can get the program up and going and
start registering these individuals and that's in section 506 of that subsection 506 all right members any questions seeing none without
objection this rule stands reviewed section f thank you section f is a
Speaker 127
1:19:27
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 their 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
Speaker 136
1:19:59
thank you in section g under subsection 302 we
Speaker 127
1:20:04
did the same thing with the requirement to keep the contact information updated wonderful members any questions seeing none
without objection this rule stands review section f or h thank you h is there the one
Speaker 127
1:20:18
where we made a lot of changes in response to the act that allowed delegation to unlicensed health care professionals, but I'll start out at section 302, subsection 302, was another area where we changed the address requirements to keep the contact information up to date. In subdivision 402 E6, the amendment to the rule under paragraph E for APRN's authority
to sign official documents follows the requirement of Act 862 of 2025 regarding an APRN signing certificates of death and pronouncements of death. Other subsection 402E9, 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 Act 431 of 2025.
In subdivision 402H, this is where we implemented the changes for delegation. So Act 959 of 2025 amended Arkansas Code 1787-107 regarding the delegation of certain nursing tasks to allow APRNs to delegate certain nursing tasks to qualified and trained health care worker who is not licensed or otherwise authorized to perform the nursing task.
These are specific, there are specific parameters listed in the legislation which have been incorporated into this
rule. All right, members, any questions? Representative
Representative Jack Ladyman
Unverified
1:22:20
Ladyman, you're recognized. Thank you, Mr. Chairman. I've got a small question, I believe, but that subdivision 402C9, when you include things like diabetic shoes, Does that make those coverable under, like, Medicaid?
Is that why that change was made? Do you all know? What's the
Speaker 141
1:22:43
the front page. It was an insurance thing where they were not accepting an
Speaker 129
1:22:49
APRNs prescription for. Specifically, it was diabetic shoes and inserts. So we just clarified that. So it was just for APRNs?
Chair
Unverified
1:22:56
Yes. Okay, thank you. Senator Irvin, you're
Senator Missy Irvin
Unverified
1:23:02
recognized. I think just general question y'all your rule kept pretty clear like your did your rules keep
very close to identical to the legislation thank you yes matter of fact we didn't have
Speaker 144
1:23:16
very many public comments but one of the public comments was asking us to increase
Senator Missy Irvin
Unverified
1:23:27
not in the legislation we can't do that no and I that's why I asked the
question I really appreciate it um thank you thank you senator seeing no further
Speaker 127
1:23:43
questions without objection this rule stands reviewed section i under sub part 105 this is also has to do with act 959 of 2025
regarding delegation of certain nursing tasks um 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 um to say that and except for what's contained in 404h 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 stands reviewed section j
Speaker 127
1:24:33
thank you the administrative procedures act 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 latest later session we realized our rules didn't include that section so we are we are hopefully going to be in compliance now and we've included that section
i use the the same language that department of health 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
1:25:17
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 i think it's
some injections that that these individuals can do now but part of the act act 265 of 2025 also changed the title from medication assisted certified to certified medication assistance there's another commonly commonly used title for another health care 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 um i will tell you about the sections that do have specific sections 102 1 a and b two of the previous requirements for certification and qualifications
were removed and that's pursuant to the act act 265 of 2025 and the training course hours have been increased to not less than 115 hours and that's also requirement of the legislation under subdivision 102 1b uh 26 act 265 now allows certified individuals to administer subcutaneous insulin injections after additional training and that that's the section is where those provisions
have been implemented subdivisions 105b8 also adds subcutaneous insulin and subcutaneous injections of insulin to the list of routes in which non-prescription and legend medications may be administered and that's also added by act 265 subdivision 105c2 there once again there was also a list of here saying that there were certain things that they were not allowed to do so we had
to accept this injectable medications that act 265 and now allows section 109 previous the rule previously the rule required that certified macs update their address oh this is this is the 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 110 a2 um we changed the timeline here for mailing renewal
notices from 30 days to 60 days because we noticed that other professionals we allow 60 days and so we wanted to make this consistent with everyone else subdivision 113 c6 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
Act 265 required. And then the last one is subdivision 113D to A. 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 going to be we don't think it's going to be a detriment to allow them 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 reviewed section l thank
Speaker 127
1:29:48
you section l is changes to the
full independent practice credentialing committee rules in act 872 of 235 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 oh so this is in to comply with act 872 of 2023 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 a5 a2 b3 act 872 of 2023 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 practitioner is replaced
with the term applicant and additionally the word nurse has been removed to use the term practitioners because practitioners cover both titles question senator yeah
Senator Missy Irvin
Unverified
1:31:13
and both of them have the same degree not correct it was just an inadvertent so that's why we didn't have to pass legislation is that
Speaker 129
1:31:22
correct that is correct and that their degrees are similar but it was passed in legislation in 2023 oh okay okay okay and we're just getting our rules in compliance yeah
Senator Missy Irvin
Unverified
1:31:33
that's what i understood that's why we 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 thank members any other questions seeing none without objection this rule stands
Speaker 127
1:31:56
reviewed section m thank you um this is this has to do with dallas's patient care technicians this is the the this is actually
the new section that we implemented in response to act 198 of 2025 and these rules were patterned after the board's rules for medication assistant certified individuals, because that's the profession that's most closely aligns with the new dialysis 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. 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 thank you any additional business by the committee seeing none senator urban anything
Senator Missy Irvin
Unverified
1:33:22
you'd like to mention before we close yes thank you um 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 Lowry Barnes our chancellor of UAMS our NCI designation submission was completed
yesterday that is a huge big deal um it's obviously the first step in a very long process but the fact that we have come this far and we have put so much effort and resources this legislature worked really hard with UAMS and the UAMS board of board of trustees and the foundation members of the nci or of the winthrop rockefeller cancer institute i just can't say enough about all of them and their hard work um 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 um our application is complete and accepted well That's exciting news
for the state of Arkansas. Thank you for that. All 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
Speaker 29
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 121
Speaker 127
Speaker 129
Speaker 136
Representative Jack Ladyman
Unverified
Speaker 140
Speaker 141
Speaker 144