ALC-JBC Budget Hearings

OK If members would grab your seat. We'll go ahead and get started. All right, members, first things first, Senator Crowe, if you would open us in prayer if everyone would stand here today. Uh, watch over, so we do the people's work and do the right thing for the citizens of Arkansas. Let us honor the. The people that came before us and honored the people that will come after us and let us. Not just have one day of honoring the veterans who helped make this country the country it is today, but every day is honoring the veterans. Bless our day and bless our travels home in your name, Lord, everybody said. All right, members. First thing on the agenda is I need a motion to approve the miscellaneous federal grant appropriation authorizations. I have a motion. I have a second. All those in favor, say ah. Hall posed I have it With that, we'll move on to the, uh, budget presentations. And Miss Walls and uh look for Secretary Putton and her team from DHS. You guys would introduce yourself for the record and then Miss Waller recognized the start, uh, change levels only, please. Yes ma'am, my name's Lila or sir, my name's Lila Walls and I'm with the Bureau of Legislative Research. Good morning, Christy Putnam, Secretary DHS. OK, um, I'm gonna go ahead and present the appropriation for shared services and then follow with the presentation for the division of aging Adult Behavioral Health Services without stopping. OK, the appropriation for shared services is gonna be on page 409 of the manual and this pays for personal services for the secretary. It's funded by interagency transfers from the other divisions. It has no significant requested or recommended changes from current appropriated levels? The next one that we're gonna talk about is the division of aging, adult, and behavioral health services and it's appropriation summaries on page 412 and 413 in your manual for fiscal year 25, the division has total authorized appropriations of approximately $313 million and with 1,157 positions and 10 appropriation bit closer to that mic. Some folks are having trouble hearing you. Um, and then the agency is requesting approximately $315.7 million in fiscal years 26 and 27, which is an increase of $2.56 million and with changes to two of their appropriations. The first appropriation with changes is on page 423. This is the appropriation summary for the division's operations appropriation, which pays for salaries and operational expenses of this division, including for the Arkansas State Hospital and Arkansas Health Center. It's funded with general revenues, federal funds, and various programs support and the division is requesting a total appropriation of approximately $131.8 million in both years. This includes increases in salary and matching of about 3.3 million in both fiscal years for a combined total of 82 million in those two line items for each year. There's a roughly $400,000 decrease in professional fees line item that the division is moving to support appropriations for salary and matching. The division is also requesting the elimination of their $340,000 capital outlay line item and, um, the executive provides for these requests except for in salary matching where the increases are limited to approximately $3.2 million total. each year, which is a $100,000 difference from what they requested. If you'll turn to page 433 and 434. This is the appropriation for community-based crisis intervention and the agency is requesting that we change this from community-based crisis intervention to crisis services and the executive provides for the agency's request. And finally, per the chair's instructions, the staff has been asked to go over amounts of recovered state general revenue for the entire department, the total amount recovered in fiscal year 2024 was $396,661 and this concludes my this portion of my presentation. Represent a vat you recognize. Thank you, Mr. Chair. Uh, can we go back to that page of 412, and it, where you're getting rid of all of the. Grants Like it's That substance abuse prevent, uh, grant. The mental health BG Oddsman. Onsbudsman, however you say that, I know I didn't say it quite correctly there. Can you explain where all of that is going now? Are you just getting rid of it all? So, um, good morning again. I did not have our deputy secretaries come up to begin with, and they are definitely going to be able to help answer some of these questions specific to line items, um, so I'm gonna ask them to, with chair's permission to go ahead and introduce themselves and then we'll answer the question if that's all right. Uh, Janet Mann, DHS. Misty Eubanks DHS. And so the, the line items that you see are, um, the division that, uh, the Office of Substance Abuse and Mental Health that we're working toward. Sorry, wrong, wrong answer, um, those are the ARP grants that are no longer going to be continued because we've reached the end of the of the grant cycle with those ARP funds. So, is it, it's funds that we're not seeking to It's federal funds that end because they were related to the pandemic. Yes, ma'am. Yes ma'am. Representative Collins, you recognize. Thank you. I was just wanted to ask about the change of the name of community-based crisis intervention and crisis services. Does that indicate a substantive change in what y'all are wanting to do with that. It does not indicate a substantive change, uh, the purpose of those dollars is to support crisis intervention, immediate crisis intervention, and it does, but it does provide some flexibility with the, uh, $30 million in funding we did receive to build out the crisis support network statewide. Um, it provides some flexibility on how those funds are used, but the intent is still the immediate crisis intervention. And could you just tell me how those would be used differently from what's being done currently when you talk about the statewide network. I think that. Um, certainly, so with the $30 million grant on the statewide, we want to do some pilots in the areas that have the current crisis stabilization units and build out a more stable model so that we can provide those services and then eventually take it statewide. OK. Thanks Senator Love, you recognize? Thank you, Mr. Chair, and I'm sorry, I'm just not getting here, but, um, My, my representative elect says that you all touched on 0NF. Have you all touched on, have, have we talked, talked about 10 yet is that coming up. OK, alright, I'll, I'll get back in the cue, Mr. Chair. Thank you, Senator. We're gonna need you to pay attention today because we're going to have to be efficient. Remember seeing no more questions on this section. Do I have a motion for executive. I have a motion, have a second. All those in favor, say ah. I opposed, I have it with that Miss Walls, we'll move on. Thank you, Mr. Chair. The next department that we're gonna talk about is the division of Children and Family Services, and it's department appropriation summary is on page 452. For fiscal year 25, it has total authorized appropriations of 315 million with 1,443 positions and 6 appropriations. The division is requesting approximately $316.3 million in both fiscal years, which is an increase of about 1.3 million, with changes only to the operations appropriation. And that summary is on page 459. Um, it's funded with general revenues, federal funds, and various program support, the division is requesting total appropriations of approximately $148.5 million in both fiscal years. They're requesting the transfer of the placement of residential licensing unit to the division of Pridevirs Services and quality assurance with the salary matching and maintenance and operations expenses, along with the associated 20 positions to be transferred over there and we will talk about where it goes when we get to that point. It's later in the presentation. division states that this unit is currently being directly supervised and operated within provider services and quality assurance, and this will just transfer the budgeting responsibilities to them as well and it includes decreases of $177,000 in operating expenses and $2700 in conference fees and travel. The division is also requesting a combined total increase of $1.5 million in salaries and matching, and the executive provides for these requests except for the salary matching, which limits the increases to approximately. $1 million total, which is a difference of $500,000 and this concludes my presentation for this division. Representative fight, you recognize. Thank you, Mr. Chair. Good morning. How will the new pay scale, uh, announced yesterday affect this budget. So, um, as was stated yesterday, the first, uh, order of operations is for us to look inside existing budget, um, salary savings and make sure that we're maximizing every dollar that we currently have allocated to this division and others, um, and, um, so that will be the first place that we look is to absorb within current salary savings. Thank you. Send her love, are you sure this is section you're supposed to be asking questions on it. Yeah, I'm, I'm sure of this. Thank you, Mr. Chair. Um. On the same on along the same lines as uh representing the fight. Did we see any, I know we're gonna see an increase because DCFS is where we've kind of struggled with kind of retention and hiring and you know the pay scale did we, um. Is it that not just the pay scale when I did we actually move the positions uh as far as their grade so that we could pay a little better for DCFS workers. So I know that the full details of the pay plan are forthcoming, they have not been released yet, but the um the job classifications as a whole, as you all heard yesterday, we are moving from about 2200 job classifications to about 800, and so the, you know, I would expect that we will see that the job classifications will change. Um, I do not know the specific details about how that changes the, the current levels, but the pay scale will change significantly for our frontline staff. OK. All right, thank you. Thank you, Mr. Chair. Representative Beatty, you are recognized. Thank you, Mr. Chair. My, my question's going, uh, kind of around the state residential treatment, uh, and on that side, I would like a little more information on maybe if you could update me on Acadia Healthcare and some of the, um, positions that the department's taking on related to that service provider. Yes, sir, we can. Thank you, Madam Secretary. So I will ask, um, Director Wright to join us to make sure I get the details correct. Um, Acadia operates several entities in the state, and some of them are mainly most of them housed out of state children and we've, um, have a current investigation underway due to some call-in reports, and that is, um, in process and I will defer to you for some, some of those details. Hi, good morning, Tiffany Wright, director for the Division of Children and Family Services, um, what, uh, deputy secretary Mann indicated is correct. There have been some concerns, um, uh, safety concerns reported to the child abuse hotline in DCFS is working collaboratively, um. To, uh, identify exactly what is happening with those concerns and working to share that information because keeping kids safe is our priority. Weren't those concerns when you say concerns, could you be more definitive on what you mean with concerns and where are those originated from or they're coming from with it outside the department or those you're concerns? Um, I can't disclose, um, reporter information. not even in generalities of, of where? No, sir. OK. So what happens during this investigative period? What, what happens with that service provider. Um, as far as what do you mean? What actions have you taken? You started an investigation, but what are the consequences of an ongoing investigation to the service provider and to those children that are seeking the residential treatment here in Arkansas. So if they're uh children from other states where they're, they're children that have problems that could be treated here in Arkansas so what happens during that time period of the investigation. So during the investigation through the Interstate compact placement of children DCFS can um deny incoming children from other states to those placements, um, if there is a current ongoing investigation, um, as far as children in Arkansas custody in those facilities we are seeing those kids, um, talking with them, making sure that they're safe, making sure they have their needs met. You said in your statement, you can deny those children. Have you actively made that determination that you will deny those children. I have OK. And, Reasoning for that just because the compact allows that. And because I believe that children need to be safe when they're entering into those facilities. So you believe that or do you have specific concerns about Acadia health. I have concerns. OK. We'llpresentative, this may, this may be an offline conversation. It will be. Thank you, Mr. Chairman. Sender hammer, you recognize. Thank you, Mr. Chair. And if you've covered this, just say we've covered it, OK, because I was a little late. Sorry about that. The, um, The proto uh. The prototype plan that was put into place for pilot program and had talked to, um, About it. Did those positions have been removed. Is that correct? where we were going to do the pilot program, uh, to kind of beef up the, the helpers here in, in Place County was where it was targeted for Tiffany, I think. Do you have any knowledge of that or we'll get to that when she gets there. Yes, sir, Senator, I believe you were talking about the teeming approach in Pulaski County, right? And that, that program has since been Stopped or that pilot program has been stopped. Is that correct? We have, yes, sir. Uh, we had trouble filling positions with that, uh, we are certainly looking to make sure that we're teaming in general as an approach, but we, we have ceased that program, that pilot. And as far as addressing the needs, Um Then of Plash County and also of the staff that was overworked because that was part of it is the whole pilot program been put to the side or we were trying to, you know, share the load or split the load up as far as who had to do what reporting and sending in two people at a time, that kind of thing. Can you, can you just give me the update on it? So some of those positions, um, have been used in, uh, across the state to support other efforts. We are also still have some of those positions. still within Pulaski County and then, um, there are several that we have listed as, uh, returning. OK. All right. And then the second question would be this, maybe this for you, uh, uh, Madam Secretary, the one time a couple of sessions ago, I think there was some legislation or something was put into place where you could do some evaluations kind of like the, over there at the, uh, uh, crime lab, I think it was the lead program, you know, because if we're gonna put money into the pay program, that's one thing, but when it comes to the management and why people leave outside of the pay. I think there was, there was something put in place. I'm also not mistaken. I think maybe that was taken out through special language. I'm not, I'm not sure about that. Can you tell me what you're doing to address the reduction of turnover as far as how it is dealt with through leadership issues at Middle management specifically. Yes, sir. Thank you for that question. Um, so, uh, a large focus of Arkansas forward has been on employee experience and um assessing the effectiveness of, uh, leaders who are in their positions and looking at those positions that may have been included in and promoted for supervisory purposes to have a promotion. Uh, we are looking to, uh, do some evaluations and surveys across agencies as part of Arkansas forward, but specific to DHS. We also have taken the actions of, um, We also have taken the actions of adaptive work programs we've implemented some job flexibility where it comes to family leave and family, uh, families at work, some of the programs we've presented to you before. Um, so from an overarching perspective, we are looking at, um, addressing turnover and retention in implementing additional adaptive work programs. We also, uh, we did complete the, uh, developmental disabilities services surveys, um, for the instruction with special language, we completed the job. site surveys, those were done and the program staff is also doing that through what's called a We Heart program. So we do have some ongoing employee support programs for the purpose of retention. OK. Last question would be, how long do you think you'll see measurable results from that 1 year, 2 years, or what, what do you think is a legislative branch we could be saying in 2 or 3 years, it's made a difference. It hasn't made a difference, or could you venture a guess? I will, um, certainly welcome my colleagues to chime in, but we've already seen some improvements in retention statistics in the past two years. So we expect to continue to see additional improvements in the next year, especially with the changes Arkansas Forward is bringing and with the, um, the addition of the pay plan that. going to address a number of our frontline staff. Representative Volt, you recognize. Thank you, Mr. Chair. So, I want to go back to the state residential treatment. Um, I know in the past we've not had the number of beds that we need. Can you tell me what the waiting list is for people to. Our Arkansan children, not out of state children, but our our Kansan children. Um, the waiting list, the number of people waiting to get in because I noticed that it's not even a million dollar ad to your request. So I, I just want to make sure that we're sufficiently funding it so that children from Arkansas can get the treatments that they need. I'll answer that one I think, um. I'm, I'm gonna start the answer and then other colleagues may join me. I'm not aware that we have a waiting list for our Kansan kids. So combination with DCFS and with Medicaid, we are trying to identify those beds and grow the appropriate, um, level of care continuum and different options. So we are trying to, to grow different options, but when those beds are needed, I think we have found them. Good. Thank you. Senator Chesfield, you recognize. Yes. Thank you, Mr. Chair, and, and tell me if I'm totally out of order because I am late. Are we dealing at all with maternal health, and if so, is that in this particular budget? Yes, ma'am. We hope to be dealing with maternal health, but we have not reached that section of the discussion this morning, I'm I'm ahead of myself. I'm going to ask you to stay away from Senator Love. But his wife is so nice. I, I cannot disagree. I certainly shall, Mr. Chair. Words from the almost was. Thank you. Senator Gilmore, you're recognized. Thank you, Mr. Chair. Good morning, Secretary. Thanks for being here. Uh, so I, I was scrolling through and looking at some of the audit findings related to DCFS and I see it right down there, uh, could, could you speak to some of those, um, I think one in particular that stands out, and there's several, um, and just candidly, I didn't read all 50 pages. Uh, I skimmed. So could you just speak to uh some of the ones related to DCFS since we're on this. particular part of the budget, um, there's $51,000 I see related to, um, insufficient records being kept on adoption subsidy agreements. And there's several pages. So would you, would you speak to those, please? Yes, sir. I'm gonna ask Director Wright to speak specifically to those. Thank you. Um, on specifically related to the adoption subsidies, overpayments, and unexecuted agreements, um, the adoption subsidies when a, um a little bit closer. Thank you a child's, uh, disruption, uh, when a child's adoption disrupts or needs to be ended and we don't catch it, um, it can lead to overpayments, and that is a manual. Tracking. And so we work closely with accounts. Um, receivable to go back and track those and so there were several that were continued to be paid after the fact that we have been working to, um, uh, Recoup the funds. So, it's specifically mentions that the agency did not receive timely notification. What can we do to fix that? So there's a, there's a several, um, reasons for that. Some of that is communication coming from frontline field staff to the adoptions unit and our central office, so working on enhancing that communication, making sure that we have the court orders so we can stop the adoption subsidies appropriately, plus also, um, the communication over to the other division. Just to make sure we have the right information going back and forth about what's happening with those. OK, so that, when you say communications, that's with DHS staff on the front lines to, I guess, central office. Also with our accounts receivable team in Office of Finance, and we've actually done a systems change to ensure that all claims will generate a collections notice with accurate claims data and that, um, we'll be in the process of recouping those and we've done all outstanding collection notices, and those have been sent. So all corrective actions in this space have been completed. Yes. OK. And so what, over what time period did this take place? Many of these predated 2010. and then once, uh, we found these audit findings, we quickly corrected. OK. Thank you. Send her low. Thank you, Mr. Chair. Uh, thank you again, Mr. Chair. Like a game is chair. All right. So, um, let, let me ask you that because it just quickly about the overpayments. Now, do you have to have a court order in order to stop the, the payments? What's, what's the, OK, right, that's, that's all I need to know. Thank you. Thank you. Thank you, Senator. Representative Volt. Sorry, Mr. Chair. Can I ask about the tan of Gramp block grant on this appropriation. Is it something that we didn't fill out for, or is it something that the money is gone from, like, it was COVID money and it's gone. Can you tell me? It's on page 452. Right, I'm, I'm sorry, I'm not quite understanding your question, Representative's a block granting paying. It had 23 million in it. It looks like it's zeroed out now. Is it something we didn't apply for, or is it something where that grant is no longer available. Mhm. Right here. So, now that we have moved TNF in DHS. We're doing allocations internally, so that is certainly part of it, and then, um, we also get contingencyanF funding, or we have when the program was at DWS now that we have brought TNF back to DHS. We've done a year-long analysis, and it appears that the state is no longer eligible for those contingency funds. So that is one part of, um, funding that we will no longer be receiving, but overall, um, DCFS does get a great portion of our TF funding and that goes to support several different areas of prevention, as well as the state police hotline and uh there's, it's probably, um, now in a different operating fund. Uh, follow up. Um, I see I can. Um, can you, can you go into a little bit more depth while we no longer are eligible for the money. So that is based on economic factors uh in the state and it's only contingency funding. We still receive the annual block grant amount that has not changed the same amount is still true, 56.5 million total, but the contingency is based on economic factors and our, our conditions have improved, which is a good thing, um, but we would no longer qualify for that contingency funding. Thank you. Thank you, Mr. Chair. Senator Hammer, thank you, Mr. She picking up on the discussion about TAA funding. What is the current balance in the, in the Uh, in the fund, in the Tanner fund. I can get that for you shortly. OK. We'll have that today. share I'd like to get that sent out to all the committee, please, first of all, just get a staff, we'll get it up. Thank you. The As I understand it. When you receive TANF, there were some obligations that you did not feel or the child did not feel that you could continue in realigning the use of TAA funds, uh, with what is the vision and goal of DHS now that you're the recipient of the TANF funds. Can you speak at a high level without going down into the weeds too deep, how you plan on using the TANF money, uh, in order to achieve what you have as a vision for, for, uh, DHS services, please. Yes, sir, and, um, a, a large number of TANF dollars have supported DHS services for a number of years, and, you know, I, I would not call it specifically DHS vision, but I would say that there are federal requirements for the TANF grant that I've discussed with a number of of the members here, um, that require us to spend it on preventing um um supporting two parent families, uh, preventing, um. Pregnancies, teen pregnancies in particular, working to support low income working families, um, and so a number of um The 10 of grants that have discontinued to this point, um, have not fallen into the four purposes of TANF, um, so that is what we are focusing on primarily, um, in conjunction with the DHS program so that we can use that all together. So the Um, organizations that were Relying on $10 have, have you pretty well exhausted the conversations with them so that they, that maybe once received TANF funds are not going to be receiving tenant funds. Have, have you pretty well gone through that, that list and made that transition, um, so moving forward, everybody will kind of know where they are. We we have made the transition for the programs, we did not feel were within the the purposes of TANF did not meet those four purposes. Uh, we're continuing to evaluate the current, the budget and where we are and we want to make sure that we are living within our means where that's concerned, um, but we do feel that the, the currently supported programs do fall within the four purposes of TAA, and then it was mentioned about the state police hotline and about the, the receiving of the calls the investigations within the budget, um. Do you think that is still the pathway forward the way it's currently structured, um, and are, are there sufficient funds, do you feel in order to meet those, the demands of the call center over there. So we do feel within the current budget, um, and the current structure being what it is that we are able to support that. Yes, sir. OK. Thank you. So no further questions, I'll take a motion for executive Rick. I have a motion, I have a second. All those in favor. Say ah. All posed. I have it. With that, we'll move on to county operations. Miss Walls, you are recognized. Thank you, Mr. Chair. Um, the next division is a division of county operations and their department appropriation summary is on page 471. The bulk of the appropriation for the tan of block grant is here, so. So that we know that, um, uh, for fiscal year 25, it has total authorized appropriations of about $280 million with 2,022 positions and 9 appropriations. The division is requesting $277.5 million in both fiscal years, which is a decrease of about 2.5 million with significant changes in 3 of their appropriations on page 475. Is the summary for the Federal refugee resettlement program, which provides temporary assistance to refugees assigned here by the Federal Office of Refugee Resettlement. The it's funded entirely through federal funds and has an appropriation of $273,000. The division is requesting that this appropriation be discontinued, meaning that it will not appear in the state fiscal year 26 or subsequent appropriation bills. Upon speaking with the division, they state that this program is being administered by the federal government, so the appropriation is no longer needed, and the executive provides for the division's request. If you'll turn the page to page 477. This is the summary for the Federal Homeless Assistance grant program. Which provides grants to local communities for their efforts to assist the homeless or prevent homelessness. It's funded entirely through federal funds and has an appropriation of about $7.3 million. The division is requesting that this appropriation be discontinued as well. Uh, they stated when I asked that this grant is now being administered by the Arkansas Development Finance Authority in the Department of Commerce, so this appropriation is no longer needed here. And the executive provides for the division's request there. Their last change is gonna be on page 484. And this is the summary for the operations appropriation, which is funded through general revenues, federal funds, and various program support as an appropriation of $190 million currently. The division is requesting an appropriation of $195 million in both fiscal years, which is an increase of $5 million combined across salary and matching. And the executive is recommending increases of $4.5 million which is a difference of $500,000. And this concludes my presentation for this division. Representative Bentley, you recognize. Thank you, Chairman. Thank you, ladies over here. I'm short. OK, thank you for all that you're doing, and, uh, probably just request Mary Franklin come up here to have a question on Act 974 that this body passed in 2019 for some work requirements for SNAP recipients, and we were graciously gave you guys some time because we're doing a complete overhaul and axios there and says, can you guys give us an update on where we are right now with that. Thank you. Glad, glad to give an update. Um, I'm going to defer to Director Franklin to go ahead and start us off. Good morning, Mary Franklin, director of division of County operations at DHS. So we have, uh, just what we have not yet implemented a mandatory snap employment training per Act 974, but I want to make clear that the work requirement for the able-bodied adults without dependents has resumed. It resumed as of June of 23, um. And so we do continue to. Close cases for those able-bodied adults without dependents who do not meet requirements and or made an exemption. We also do continue to still offer and provide services to those who volunteer for employment and training. And if those able-bodied adults do not, uh, take advantage of employment and training or other things like work or volunteering, they do lose their coverage after 3 months and they do. In a 36 month period. Just a quick follow up, Chairman, if that's OK. So, um, yeah, thank you. So ladies, thank you so just re-clarify for us, so even though we've not put the mandatory policy in place. Actually, the federal requirements are actually doing exactly what we were the intent of what we had in Act 974, can we say that's correct. OK. Yes, ma'am. All right. Thank you all very much for your time. I appreciate it. Represented love, we have made it to the tenant funds, so you're recognized. I'm not gonna say thank you, Mr. Chair, again. Uh, so, um, I'm, I'm on page 477. Um, in the homeless assistance grant now did you all say that was transferred to advo because I did not see. I know we went through ADFA's budget. And I didn't specifically see this program. In at for budget. Yes, Senator, that's correct. ADFA, Arkansas Development Finance Authority is now administering the emergency solutions grant, starting with this federal fiscal year, uh, we are still closing out federal fiscal 24 because DHS did administer that fiscal year, but, um, ADFA is starting the grant that was effective October 1 of this year. OK, uh, well then, Mr. Chair, this is what I'd like to do if Kevin could do this flag AA budget. I would want to flag at this because I did not I did not see this in AA's budget. I know that they went through their CDBG and they went through all the the things so please flag the budget for the homeless assistance grant program that flag's been applied in your name. All right, thank you, sir. Representative Beatty, you recognize? Thank you, Mr. Chair. Uh, going back to, uh, Representative Bentley's, uh, questioning on 974 and, and the rule implementation, uh, Can you explain why since 2019, we haven't implemented that rule. Yes, sir, I will start, um, and then I will ask Director Franklin and of course, some of that time predates, um, my time here in Arkansas, um, but I would like to, to flag that, uh, 2019, we then went into 2020, which, of course, you know, many of the federal requirements were paused during the pandemic, during the public health emergency, uh, Director Franklin indicated that we did resume the general work requirements for SNAP, um, in June of 2023. Um, Snap has meant they have work requirements in place. They are required of all able-bodied adults without children, um. The employment and training program is a, is a separate piece of that. It's a mechanism through which people can access employment and training services. Um, we do have providers throughout the state who provide these services, um, and I will defer to Director Franklin to give some details on those providers and, um, where we currently are, but we had not completed implementing the mandatory portion of it because that is a requirement on the state to build out those services and require participation instead of individuals accessing employment and training. on their own. It requires participation through the state program. So we do, we do have several providers, uh. Career education through, uh, Department of Commerce is one that is statewide. They do provide services statewide. We have, um, A couple of other we have our house that also does employment and training in Pulaski County, um, Arkansas education, employment, Arkansas Employment Career Center does, uh, provide services here in Pulaski and in Jefferson County, Northeast Arkansas Community College is one of the providers, um. This is from the top of my head, so, uh, We have another one, Allied Health in Garland County that is a provider, so, um, even we do have some coverage like double coverage since career education does provide statewide coverage, but we, uh, we do not have the capacity that would be needed even though we have statewide coverage to manage the number of individuals that would be required, um, based on Act 974, so that is something that would have to continue to be built out. Um, and other, other explanation for why it has not been implemented yet. I mean, as, as you're aware, we did, we had the pandemic and, and we weren't able to make progress on that during the pandemic. Most of the work requirements were, uh, federally. Um, suspended during that time, and then since then with unwinding the pandemic and other, other things that we have been dealing with, we just have not, um, been able to fully implement or get to the point where yet, where we're able to do mandatory employment and training. Just just field you recognize. Yes. Thank you so much and good. Is someone laughing? I sure hope they ain't laughing at you. That's brave wouldn't it? It would be a tremendous mistake. First of all, allow me a point of personal privilege to introduce to the bodies to the bodies, our newest members, Representative McGruder and Representative Burks. Let's give them a round of applause and welcome them. And we just look forward to great things from you gentlemen. And we women will help you do better, OK? Now. Moving right along, uh, Madam Secretary, you know, one of my concerns is TANF, uh, and in that area of Chana, I am really, really concerned too about the GED program. Is it totally from within your bailiwick? Are you still, are you still working with some aspects of it. So we are still working with some aspects of it. Um, one of the things we've been trying to do with Tan and with all other things within the department is where we find duplication between other agencies. We've been trying to partner and collaborate with them to make sure that we're not spending money twice, um, the GED program is a good example of where we were spending money twice because we had, um, statewide coverage for GED and adult diploma services through our career pathways initiative, uh, what we were able to do is we were able to work with um uh Commissioner Warden, and Um, make sure that we could have those services covered, partnering with the career pathways initiative. And so we were able to reduce some of that funding, but also provide the services, the same services statewide. So I'm gonna ask you as I ask him, can you assure me that GED programs are statewide. And that our citizens have access to something that makes such a tremendous difference in their lives. Yes, ma'am. Thank you. Thank you, Mr. Chair. Representative Richardson. Thank you, Mr. Chair. On page 475. Looks like you guys have zeroed out the, the refugee program over the next couple of bienniums. Can you, can you give me some idea of, of, of why you thought that was necessary and, and the purpose for that. Yes, sir. First, I want to point out that zeroed out in our budget does not mean they are not still receiving medical and social services. Um, there are several options for a state to address, um, the refugee resettlement services, one of which is complete. federal oversight and administration of that grant. We previously did not choose that option. We had a partial state, um, administration of the refugee resettlement grant. Um, we retained that for a period of time because we were concerned that we would not have access to the reporting information and have an understanding of who was coming and how we could best support them. Um, we have had further conversations and there's there was actually a bit of a change in direction at the federal level that allows the state to sit at the table, the coordinating council meeting. for those refugee resettlement grants, even if we do not administer them, and I'm sure that if I left anything out or misstated anything, Director Franklin can provide additional details. Thank Senator Gilmore, you reckon? Thank you, Mr. Chair. So. Just circling back to Act 974, just so I understand. We passed a law, the legislature did, and then We didn't implement the law. I know there was a, If I remember correctly, I think there was 2 years given to implement that, but we didn't implement it because the federal requirements already allowed for. Um Work requirements or what, what was the reason? The requirements do allow for work, but that was not the specific reason initially we were in the middle of the pandemic, so all federal work requirements and other requirements were paused. Those did not resume until the end of the public health emergency and that actually resumed in June of 2023. So it's actually been about a year and a half, uh, we have been, uh, working with providers to expand our provider network for staff employment and training. We have not implemented the full mandatory aspect of the program, um, and we would, um, actually welcome some further discussion with interested members on that and the approach to that. Uh, what we would like to avoid is creating additional programs where there's not a need, and we want to seek input on that. Fair. We don't want to create any more programs without need. I just, uh, what effort was made at the, uh, granted, you weren't here at the time. What effort's been made though to have a conversation about, uh, this particular act that the legislature passed and why it can't be implemented or, uh, because I, I think what concerns me is if we pass laws of this legislature, and for whatever reason, it's burdensome or costly or whatever it is, the agency just decides not to implement it. I mean, I think we need to have a conversation about that, wouldn't you agree? I completely agree with you, and it is at this point that I'm pursuing that conversation. It was not something that was raised during my first year here. We have recently discussed it as far as, um, the upcoming session, and we would like to discuss, uh, you know, what the details of a mandatory SNAP ENT um program actually placed on the state versus individual responsibility, um, because to your point, we're not in the business of growing government programs, but we are in the business of growing individual empowerment and self-sufficiency. couldn't agree with the statement anymore. I, I would just like to add, um, so you're, you're coming and asking for a repeal of that law in the session. Uh, that is something that I would like to discuss. OK. Thank you, Mr. Chair. Senator Hammer, you recognize us. Thank you, Mr. Sheer, and uh, you may provide this information before, but like when it comes on, when it comes to the federal requirements of reports for entities, nonprofit or otherwise that receive funding state or federal, and whether or not they are delivering. In a measurable way to show success for the money that they are getting. Are there reports out there that are accessible both to us as legislators, but also how easy is it for the public to find those reports. Senator Hammer, are you speaking specifically to TANF for in general? Probably in general, I'll just, let me just, you mentioned our house a while ago, so I'm not picking on them. I'm just citing the example for, for illustration purposes for our house and the amount of money that they're getting and you cited something that they were doing a while ago. What does the agency do in the way of. Uh, compiling reports to show measurable success and results in the areas where they are receiving money. Whether it's federal or state dollars to know that the investment is actually getting a return. So I will start and I will invite my colleagues to chime in as well. Um, there are a number of different federal reporting requirements specific to, for example, child welfare, there are not as many federal reporting requirements, uh, associated with the TANF funding. It is a block grant, um, part of our, um, addressing tanist to also look for for entities that are producing outcomes and have measurable results, um, but we also are looking across the board, you know, we do have, um, results and reporting requirements for our, our employment and training providers. Our Snap partners, um, and so there, there's a litany of reports that we are required to make to the federal government with outcomes and especially with our outcomes in our, our, our snap processing rates are Medicaid determination rates and our timeliness, um, we're sorry and spending, um, and so if there are specific questions that we can help answer, we're glad to do so. We do have a DHS annual report that's online that has a number of these reports in it, and we're glad to provide the link to staff for distribution to this committee. OK, so like, I'm gonna say it's tobacco settlement, we get an annual report on that, you know, and, and that, but A one stop does it all place where all those reports could be accessible to the public to look or for us to have it easy, or we're going to have to know where to go and how could, how could that be achieved. We, I think we do have, um, a one stop in our DHS annual report for the programs that DHS oversees, um, so we can provide that and make sure if there are suggestions for how we can make that more easily understandable. We'd be glad to work with you on that. All right, I'll get off flying with you. Thank you, Mr. Chair. Thank you. Thank you, Senator Representative Beatty. Uh, thank you, Mr. Chair. I had, had a follow up back on 974 when, when I had staff reach out to the agency, uh, about outstanding rules, uh, Act 974 was not on that list. Has, has it, has it now made it to that level that this is something that you will actively be working on to procure a rule or as, as Senator Gilmore asked, move forward in the, um, in the coming session to repeal Act 974. We would like to have the discussion about whether we should pursue those rules, and we would respectfully request to have that with, with the legislature. Thank you. Yes, sir. So no further questions. Do I have a motion for executive Rick? A motion of 2, 2nd, all those in favor, say ah. All posed. I have it with that Ms. Walls. We'll move on to the next item, the developmental disabilities. Thank you, Mr. Chair. The appropriation summary for developmental disability services is on page 496 of your manual. It has total authorized appropriations for fiscal year 25 of $211 million with 2,503 positions and 8 appropriations. The division is requesting a total of approximately $219.5 million in both fiscal years going forward, which is an increase of approximately $9 million with changed to two of their appropriations. If you'll stay real close to that. If you'll turn to page 502, sorry, this is the summary for Children's medical services Federal Appropriation. This is funded entirely with federal funds. This division is requesting an appropriation of $446,000 which is a decrease of $1 million to better align the appropriation with projected funding and the executive provides for the division's request. The other change that they're requesting is on page 509 in the operations appropriation. This supports the operations of the division, including the management and operation of the Five Human Development centers. It's funded with general revenues, federal funds, and various programs support, and the division is requesting an appropriation of $201 million in both fiscal years of the biennium, which is an increase of approximately $10 million. This, uh, they're requesting increases of $11 million in each of those years for salary and matching combined, and they're also requesting that they're, they have an extra salaries line item they're requesting that that line item be taken to 0 and that that $27,000 be shifted in their into their professional fees line item to support additional costs for medical services due to their inability to hire full-time employees in specialty medical positions, including physicians, nurses, psychologists, and dentists. There are also requesting a $65,000 decrease in conference fees and travel to align with their budgeted levels and requesting that their capital outlay line item be reduced to 0. The executive provides for the division's requests apart from salary matching, which they recommend to only increase to a combined $148 million which is a $1.5 million dollar difference from the request, and this concludes my presentation for this division. Thank you, Ms. Walls. General Barry, you are recognized. Thank you, Senator Rice, and I don't think I'll be criticized now if I, uh. If this is not the right place for this question since uh word law is gone, but I had a question about the, uh, uh, children's health insurance program. And in the audit findings there were 26 pages of audit findings, uh, on children's health insurance, uh, material weaknesses, non-compliance, uh, some repeat findings. Can you Tell me what we're doing to fix, uh, the issues that we have over there because they're they're pretty, pretty significant findings. Yes, I'm gonna ask Deputy Mann if she will speak to those findings. Yes, sir. um, when the chip is audited, it's also audited in combination with the Medicaid cluster. So we do have some repeat findings that happened in that area. We've, um, we had some eligibility corrective action, and then we had some other adjustments made with, um, our matching and our reconciliation process. We worked through those and added, done some corrective action plans, also worked with, um, our Office of Internal Control. to better, um, process and handle those procedures, and then we've continued to work with CMS as our federal partner as we clear these audit findings every, every year. So Madam Secretary, so you're confident that we're at a point where, uh, the material weaknesses are be identified being identified and, and fixed. They're being identified and addressed. Yes, sir. Thank you. Thank you, Madam Secretary. Thank you, Mr. Chair. Thank you, Central Chesterfield, you recognize. Thank you, Mr. Chair. Mine is a point of personal privilege. I saw Mary Franklin leaving, or I thought she was, and I wanted to tell her publicly. How much I truly appreciate the fact that when so many of our citizens need her. She's just a phone call away. And we don't get to say that to our staffers very very often. Such has also been true with the secretary and the rest of her staff, but Mary, even on a Sunday when there was a couple who had just become homeless. She worked with them to get them some place to stay. I think that's going above and beyond the call of duty and I just, would you stand Mary? I wanted to say that to you while you were still here. I appreciate you so much. Thank you, Mr. Chair and thank you, Secretary Putnam for also being um always responsive. I appreciate it. Thank you, Senator. Senator Leadding. Thank you, Mr. Chair. Uh, good morning, Madam Secretary, and apologies if you touched on this in some of your early, earlier comments about the changes coming to the pay raises, but um, What, if anything, can the department do to help raise pay for independent living, personal care assistance, you know, the people who go and staff our Kansans living with disabilities. Uh, so we have not touched on that piece. We are looking, um, and we have published on our website our rate reviews. We are, we have started those again. We've published how we're going to handle the process of the rate reviews also the order of which we will be doing them. We, um, will be starting with dental and then we will be moving through, um, when that, in addition, when those waivers are renewed, they go through, um, some fundamental research and compilation. So we will be getting all of that work, um, well we have begun that work. And so we are very aware that, um, personal care has brought it to our attention, um, on the wage and labor issues. So I think they are scheduled early in the spring. of next year. I'm, I'm struggling so I'm trying to remember the schedule in my head and I and I don't, but it is published, and we can provide that. OK. All right. Thank you. Thank you, Mr. Chair. Representative Ladyman, you'll recognize. Thank, thank you, Mr. Chair, over here, um, well, I, I had another question, but Senator Lenning brought this up. Uh, that is an area where we need to really look into that. Uh, I've met with a number of facilities there in Jonesboro and, and they're struggling. To keep people and uh they really, they really need a, a review as soon as possible. Um On page 509. Uh, the capital outlay line and I asked this question yesterday. I didn't really like the answer, but so I wanna ask it again, we're zeroing out these capital outlay, uh, lines. So, what was that money used for before and how can we zero that out if we have facilities that we need. Capitals expenditures on. So we, we actually have actually have a master and capital development plan for our HDCs, um, and I would like to invite uh Director Bris to come to the table and speak to that and and possibly, uh Mr. Tarpley. To just give an overview of what our capital planning is for the master plan for the HDCs. Jennifer Rosse, director of the division of Developmental disabilities. We do have a master plan, uh, that we have run by and have been approved by our developmental disability board, our money for construction right now is that we have is focused on our two, sinners that have the dual diagnosis, most complex population and so we are working on finishing and holding out Boonville and Warren, southeast Arkansas, the Human Developmental Center, and then our third priority is the, the Conway Human Developmental Center, which is our only HDC that has children. But now this line item is just for normal, like air conditioners and that sort of thing, isn't it? I mean, did that money go somewhere else, that million dollars? I mean, is that addressed somewhere else in the budget? The capital outlay. I'm going to ask Mr. Tarpley to speak to that. We do have one DE funding historically that can be used to Purchase the items that you're talking about, whether it be uh any type of capital equipment, HVAC, uh, boilers, chillers, so that is covered somewhere else. Yes, we do have appropriation of funding, thank you. More centralized approach representative. Seeing no further questions, do I have a motion for executive Rick. Have a motion in a second. All those in favor, say ah. I posed, eyes have it with that Miss Walls, we'll move on to medical services and understand there's quite a few changes, so. Good luck. Thank you Thank you, Mr. Chair. Uh, this is the division of Medical Services, it's department appropriation summary is on pages 5, 16, and 517. It has in fiscal year 25, it has total authorized appropriations of $10.6 billion with 93 positions and 14 appropriations. The division's request is for total appropriations of $10.6 billion and there is a chain decrease of about $4 million in their total, but it's small enough that it doesn't really appear easily, and they're asking for changes in 8 of their appropriations 7 of those changes are in Medicaid. Related line items, but we'll start on page 523, and this is to The excuse me, this is the Medicaid tobacco settlement appropriation for prescription drugs. This is funded through tobacco settlement funds and federal funding, and the division is requesting $5.1 million which is a decrease of 4.4 million to align more closely with historical spending levels and the executive recommendation provides for the division's request, request on page 524, which is the next page, is the summary for the hospital and medical services line item of the. Medicaid tobacco settlement appropriation, which is also funded through tobacco settlement funds and federal funds, and the division is requesting $140.4 million which is a decrease of $20 million to align more closely with historical spending levels. The executive recommendation provides for the division's request there as well. On page 535 is the operations appropriation for the division of Medical Services. It's funded through general revenues, federal funds, and various programs support. The division is requesting a total of $12.9 million which is an increase of about $400,000 and that entire increase is being requested in salaries and matching. They are also requesting a $100,000 decrease in operating expenses to take it from 1.8 down to 1.7 million, and with a $100,000 increase in professional. these line item for to take it from 7000 to $800,000 to support increases in legislative audit invoices. The executive recommendation provides for the division's request apart from the salaries and matching, which is a recommended increase of only $280,000 each year, which is a difference of $120,000. The next 5 appropriation changes they're requesting are in the Medicaid grants line items. Appropriation and they pay for specific types of services in the Medicaid program. On page 541 is the summary for the prescription drug line item of the Medicaid grants appropriation. It's funded through general revenues, federal funds, and prescription drug rebates. The division is requesting $625.6 million in both fiscal years, which is an increase of $40 million to better align with anticipated expenditures and the executive provides for the division's request. If you'll turn to page 542, which is just the next page. This is The summary for the private nursing home care line item of Medicaid grants appropriation, which pays for expenses for skilled nursing home care. It is funded through general revenues, federal funds, and the quality assurance fee. The division is requesting $1.049 billion in both years of the biennium, which is an increase of nearly $42 million to align with anticipated expenditures and the executive provides for the division's request. On the next page, page 543 is the summary for the Archis bee line item of the Medicaid grants appropriation. It's funded through general revenues, federal funds, and various program support. The division is requesting 167. $7 million in both years of the biennium, which is a decrease of nearly $40 million to align more closely with historical spending levels and the executive provides for the division's request. On the next page, page 544. Is the Hospital Medical Services line item of the Medicaid grants appropriation, which pays expenses for all of your waiver services and any service that's not paid in another grants line item. It's funded through general revenues, federal funds, and a variety of other state funding sources and the division is requesting $8.336 billion in both fiscal years, which is a decrease of 20 million. To align more closely with historical spending levels and the executive provides for the division's request. Their last requested change is on page 549. This is the summary for the infant infirmary line item of the Medicaid grants appropriation. It's funded through general revenues and federal funds, and the division is requested $330,000 for both fiscal years, which is a decrease of $2.26 million to align more closely with historical spending levels and the executive provides for the division's requests there as well. And this concludes my presentation for medical services. Seeing no question. Do I have a motion for executive right. Oh, I got some questions now. You guys are going to get faster. Representative Bentley, you recognize. Thank you, Chairman. Thank you, ladies for here. So I'm looking on page 544. Our hospital medical services. Is that where we pay for labor and delivery for, um, Medicaid recipients. It, it would be, yes. So I see that we see, I see no increase in general revenue, so you telling me we're not going to have any increase in the amount of money that we're spending on labor and delivery for Medicaid recipients in Arkansas. No, ma'am, I'm not saying that, but I'm not saying that we are either. We have been working with um our partners at DFNA and others working on our fine tuning our budget. We are hoping to have um some increases there that we have not finished working on those details yet. Follow up chairman, please. OK, so let's get, get to the fine tune of this, so you tell me that we're not going to increase, uh, we need to know one way or another. So if we are going to increase it, are we giving ourselves room to be able to increase the amount that we need to increase for these services for, for the women in Arkansas. Yes, ma'am, I believe so. We have the appropriation for any funded increases. OK, I just, when I look and see here, um, that we're decreasing our general revenue assets me concerned that we're not going to have the funding that we need to make sure we can increase those as we need to. Yeah, we're, we're decreasing our appropriation to align more with our spending. So I don't, we're not proposing any decreases. We do believe the appropriation will allow for, um, any additions that need to be made, and we, you know, as you all know, this is a priority for the governor. We certainly don't want to get ahead of the governor and, and we've been in conversations with governor's office and DFNA on, um, addressing specific investments in, in areas such as maternal health. OK, thank you. Representative Meeks, you recognize. Hey, Mr. Turner, I'm way over here, dear, far, far right, way over here. Um, so the, the question I have is on 5, 16 in our budget manual, the very first line, the nursing home quality appropriation, uh, looks like you have $4 million in spending authority, but only spent 3000. So I, I guess my My, my question is, Do we need $4 million in spending authority or have we just not spent. That money or is this something we no longer need? So can you kind of go into detail on that for me. Thank you so much for that question. Um, this is restricted funding and the appropriation is only used in emergencies, so we go in when we have a nursing home that fails for whatever reason, we need to pivot quickly in those emergencies sometimes we install folks to, um, run those on our behalf. We purchased. food, we do other emergency type things and for a long time, about 20 years, we were blessed not to be in that position, but about 5 years ago, we began encountering some of these instances and in that event, we would like to have and definitely need quickly the appropriation available here. OK, so if there were no emergencies, we had a perfect year, we would have zero spend on this line item, is that correct? OK, it just says nursing home quality makes me think, are we supposed to be doing quality checks that we're not doing. That was kind of my first assumption, but that sounds like maybe the issue is we need a better label for that line item civil penalties here through the nursing home quality assurance fees that we do collect and so it's named for the, the revenue there. OK. All right. Makes sense. Thank you. Thank you, Mr. Chairman. Thank you. Representative Pilkington, you recognize. Thank you, Chairman. Um, on page 549, the infant infirmary. Uh, I saw that we had a reduction there, uh, but I can see the historical spending. Can you just kind of walk me through why we never spent that amount that was appropriated? I mean, is it just, there wasn't a need or I, I, I would like a little more background on this reduction to the infant infirmary. Yes, sir. I'll defer to Director Man to Deputy Man to give specifics, but in general, we are trying to reduce appropriations to align more with the historical spending and this is one of those areas, uh, we have not seen the spend in that area. Yeah, and I will just, I will just add that historically we've not spent it, so we've actually asked for it to be reallocated into private nursing facilities for better, um, better use of spending, but the background you're asking me about, I don't have. I will have to get it for you on the, on the history. OK, that, that's, that's fine. Um, I just was curious, it would seem like a lot and we got nowhere close to spending that amount that we put into it. Uh, but then that your statement that raises another question, uh, if you'll give me a little latitude on. So you said that we're reappropriating that funds to private nursing facilities from the infant infirmary. Did I hear that correctly or did I miss? No, sorry, um, we've all reallocation of money from the infant infirmary to private nursing home care, um, to a different fund to better align with the historical spend. So it's a different fun. OK, I got you. All right, thank you. Appreciate it. Didn't understand. Senator Gilmore, you recognize us. Thank you, Mr. Chair. So just following up on the maternal health. When can we expect to see some specifics on, uh, changes that you guys wanna make to maternal health policy, uh, and ways to target that, that sub population. So we actually have already started making some changes along with our partners at Department of Health and other community partners and hospital systems, um, and one of those changes is we've got some pilots going with uh with the five areas on prenatal care, and we've already seen an increase in prenatal as. specific additional spending, um, you know, again, I, I do expect that, uh, you know, the government will be presenting next week. Again, don't want to get ahead of that, but I know that this is a priority for her. And presumptive eligibility. We, we are already working on, uh, implementing presumptive eligibility for pregnant women, um, so that they can uh go ahead and get the 1st 1 or 2 visits in, uh, to be automatically determined eligible and then complete the eligibility process. So that is already underway. OK. So, I know, again, predates you, I believe, but this legislature passed our home, which was basically a redo of our AR Works, which was a redo of you, you follow. So where are we in that? Because a lot of that had maternal health in it, a big percentage of that was maternal health, if I remember correctly. Are, are we shifting from, from that policy, um, I, I just, I don't really know what was actually implemented with that and what we're still doing if we're doing any of it. So with, um, the our Home waiver, we did have maternal life 360 as an option, um, add-on for several hospitals. We have just gone live with two hospitals, um, I believe, and then a third coming online very soon. So maternal health is still a focus with the our home population. We do have metrics that we report on every quarter in a public meeting with our home on those metrics with the carriers, and then we are looking for ways to improve that. In addition, we did get, um, approval on a state plan amendment to do some home visiting in the our home section and we were allowed to extend that to pregnant women outside of the our home and we are working to implement that. It, um, I think it will be billed as a targeted case management and we're working through those systems, through those system changes, so that all pregnant women will have some additional options. So are we going to pursue something to replace our home at some point. So. A new waiver. Our home is up for renewal this session and, and so that is part of the ongoing work that we have ahead of us. Yes, sir. We have to replace it with something, yes. Thank you. Huh. Senator Love, you recognize. Thank you, Mr. Cha. I didn't know that I was only caught like that, but alright, um, you're next in line. Yes, staying with, staying with maternal health because I, I actually just received a text, um, in regards to, you know, This, this person's asking me about uh programs for maternal health, but, um, are you all working with any specific programs cause they were texting me about a program like my baby for me. Have you, have you, have you heard about that program or is there a comparable program that we're working with through maternal health to so. I have, that's the program with DCFS. There's lots of names floating and so we do work with them on that program. We've worked with the Department of Health. We've worked with several partners within the state. We have applied for the transforming maternal health, um, CMS grant, which we're hoping that will be awarded, um, late December, early January, um, so we have had also lots of inquiries with the focus on maternal health with interested parties, and we've not turned down anyone. but we've not done anything with them. We want to see how we get funded with the grant. We're hopeful that we will get funded with that grant and then that will set some of our priorities moving forward and then in conjunction with legislative session, continue those maternal health. uh just like for instance we are funded do we have an apparatus already um set up to actually. Um, get providers in disperse the funds we, we already have that apparatus or where we have to create a whole new apparatus will try not to create a whole new apparatus we will try to use what we already have with our, with our partners, be it, um, through the claims or through another entity that helps us, um, do some of our work every day, such as AFMC just as an example, to do some review work. So I'm hoping, I don't want to create a brand new system. I would, I would like to add to the current system. and expand it so that then it's all in one setting and that we can measure the results. Well, please keep me abreast of what's what's going on and I think Senator Gilmore would like that as well, um, my, my last question is this is that I'm seeing these budgets for um nursing homes, you know, we have a private nursing home care we have a, a public nursing home care. Um But then where, where do you have, uh, um, the budget for community service providers. I mean because I'm, I'm looking at that that's a kind of a comparable system so where is it in here that I could find. So it's going to be in a combination of our accounts. So Home and community-based services, um, are paid through fee for service and through our past program. So they will be paid through hospital and medical, but you may not see them as a separate line item here. On these different funds. OK. How much, how much would we, would you say we spent on community-based service providers as far as making sure our loved ones can stay at home. Um, you would ask me a specific, um, we can get that for you it for you. I was trying to think. I don't have the 631 24 numbers in front of me, but I'll get them. OK, if you can get that for me, I would be, I would be interested just as a comparison because you know as as we move forward, a lot of us want to keep our loved ones at home, not saying anything my mom went to a nursing home and I was happy for the nursing home association helping me with that, but I'm getting more and more people are saying, hey, I don't have the, I don't have what it takes to kind of Keep my loved ones at home and they wanna stay at home. I'm going through that with my uncle right now so that's kind of uh how my priority is list of saying. That we need those services as well if we're gonna undergird our loved ones so if you can give me that information, I would, I would appreciate it. Thank you, Mr. Chair. Thank you. Senator Hammer, you recognize. Thank you, Mr. Chair. Um, I'm gonna be on Cheryl on 5. 41 Believe it's going to be dealing with, uh, prescription drug. conversation, I noticed, if I'm reading this right, That the rebates are projected to go down from what was actual in 23, 24. And brought, put it out to 26, 27. It's showing that the drug rebates to go down, could you talk about that for a second, please. Yes, sir. Our rebates are, um, collected. 2 quarters after they are eligible. So some of this could be timing, um, and some of this, um, could be something else. I will have to get you those details, uh. I mean, a rebates fluctuate depending on what is, um, prescribed. And they were eligible for. Based on that comment then. How do you arrive at a figure that you can defend if it's, if it's determined by past history. How are you able to defend lowering the number. Out into the future. And I, I know it's a volatile area as far as predictability, but what's the rationale for how you arrived at it. Is it based on the last, you said the last two quarters or would you say the last what? So I would say on our based upon our historical spend and that it has leveled out, that would have been the basis for lowering the, the amount of a small amount, but we always, if we are able to gather more rebates, we will come before you for the, the authority to do so. OK. So, I mean, based on what you just said, my take away from what you just said is that The cost of the prescription drugs is leveling out. So as far as, and looking at the number you're projecting, they may actually go down because otherwise once you keep that drug rebate number inflated at a higher number instead of Lowering it as much as it is. That's a 65. It's about $62 million drop. Or am I, am I reading it wrong? No, sir, we are trying to keep our budget as level as possible. And so with doing so, based upon our historical spend, we have, we have been as flat as possible in our estimates. All right. Um, and, and refresh my memory, and this touches on another subject when it comes to the discussion about the, uh, dispensary fee. Are you, are y'all, you're subject to that or that's already included in these numbers. It is in these numbers we pay a dispensing fee that is separate from, um, anyone else. We pay $10.50 per prescription for for preferred and generics, and then we pay $9 for brand and non-preferred. Where is that? reflected in these numbers, which one of these categories does it apply to? It would be in the line item of prescription drugs. It's, it's calculated with the cost of the drug plus the dispensing fee is the total cost of a prescription drug. OK, and you're showing in your budget to go from 525 to 625. Is that the line item? Is that correct? That's correct. OK, so are you attributing the increase of cost to your prescription drugs and strictly to the cost of the drugs, but, but if historically you've been paying for that already, that would not be reflective as a reason why the cost is going up, would it? I'm gonna need you to ask that again. I'm sorry. I was looking, OK, well, you, you, how long have you been paying the dispensary fee? For as long as I know, yeah. All right, so the, the number of prescriptions. Is it going up or is it leveled off? I know, I know the, the cost of the drugs may fluctuate, but historically, as far as the number of drugs that are administered that that cost would be assigned to. What is it doing historically? If it was 5 million last year, is it 6 million this year. I don't have the historical number of prescriptions. I just have that we did 4 million prescriptions last year. So I will get you the historical. OK. And I'll wrap it up, Mr. Chair, but, but what I'm trying to get to is the, the, the projected increase in your pres prescription drug cost. You've had the dispensing fee factored in there for as long as you can remember. So really, as far as what you're projecting as far as an increase isn't going to be attributed to the dispensing fee. It's going to be attributed to the cost of the drug. Is that a fair statement? That is a fair statement. So the dispensing fees had no effect on the cost of medications that Medicaid is paying for. Other than what's been in there for as long as you can remember. Is that right? There's not been a change in the dispensing fee. So that was not factored into any increases in our prescription drug costs. Yes, that is correct. OK, thank you. Senator Chesfield, you recognize. Yes, thank you, Madam Secretary, you know my great concern when we turn down the federal money for maternal health. And that was followed by. The report that I read indicating that you were going to try to engage uh in grant writing to secure the funds that were necessary. To make up for that which we lost, or which we decided not to accept. How much money has come in, how much were we to have from the feds? How how much was the Fed gonna send us? Was it 100 million? I think you're referring to the 12 month postpartum. It would have been, um, Whatever the level, whatever the eligibility category was, it would have been the federal match for that. So without knowing a certain number of women who would continue on 12 months postpartum, we would, I would not know that number specifically, but it would be the federal match for that. Um, and as we've testified before the 12 month postpartum, um, and, you know, I know that we are, we are working on that connection, uh, when women reach that 60 day postpartum mark and they need to transition to a different Medicaid eligibility category or need assistance connecting to marketplace plans. Um, that is the part in the process where we are currently to make those connections. Um, but we, um, you know, we currently are not leaving money on the table as far as that goes, because we are, any woman who is eligible is continuing in whatever eligibility category she has, so it just may not be within this particular category, but after a particular period of time, we're going to transition them into something else. Yes, ma'am that will allow that. Uh, also of great which gives something which gives me great angst is the number or the numbers as they concern black women. in postpartum care. Because the disproportionate number from what I'm gathering die. than their counterparts in other ethnic groups. Could you speak to what we are doing to address that discrepancy. So one of the things that we're doing, I mentioned earlier, is we are doing a five-county pilot in the areas of greatest need across the state in conjunction with the health department to, um, connect with women who are not getting prenatal care in the first trimester or the 2nd trimester, they're waiting until the 3rd or they're waiting until labor and delivery. And, um, I don't have the counties in front of me, but I'm glad to reiterate those counties we have from the period of April through September, and I don't have the most recent statistics, but we'll get those for you. We have seen a significant increase in women accessing prenatal care, and those are some of the areas that you indicate. And, and the numbers are going down as to those who die as a result of a lack of of of care. And that would be across the spectrum because women are not always believed in hospitals. That's correct. And that is so concerning to me that when we tell people this is how we're feeling, people are not taking as seriously as women. And I need to know that being the Department of Health and Human Services, partnering with the Department of Health, that we are pushing to make sure that women are respected when they're in this very vulnerable period, uh, because They deserve that kind of respect, would you agree? Yes ma'am, and part of our input with the maternal health recommendations was uh provider education and making sure that we are actively working on, um, communicating with family physicians and also with hospitals. Alright and having success in getting the grants that you have applied for as a result of that and I'm I'm I'm through after that Mr. Chair. We, we are very, um, hopeful on the TEA grant. We have received questions back from CMS that are due tomorrow. So I think that's a good indication that they are on schedule to make decisions. It is a competitive grant. It is a 10-year grant with 3 years of implementation and technical assistance. And so we are positive that we are at least in the running. So we are hoping that we will be granted the award. That is my hope as well. Thank you so much for taking my questions. Thank you. Senator Chesterfield, we're going to let you have all the time you need because we only have 45 days left of you. Representative Ladyman, you are recognized. Thank you, Mr. Chairman. That's a hard act to follow. Um, I want to go back to and and there's been a lot of questions about maternal and infant mortality and what we're doing, and everybody knows that's a focus for all of us. Uh, and we beat around this bush, but I don't think anybody's asked this question, and if I'm repeating something, I, I'm sorry, but, uh, Representative Bentley ask you back on page 544. Uh, about, uh, why, why didn't we increase the request? So when I looked at that, You actually spent What is it? 7.1 billion, and you had authorized 8.3 billion. So what is preventing you from spending that full amount since we know this is an area that we really need help on. And I don't know, maybe it's personnel, maybe it's having the management structure, but, but why, if we have such a bet, which we do, we're 50th in infant mortality. Uh, so why can't we spend that money. And I know y'all are trying to balance your budget. I, I, I agree with that, but we've got money allocated. We know it's a big problem. So why can't we spend the money we have authorized. Um, I'm gonna start, uh, we, um, pay our claims every week and we pay our clean claims. So if when they When the providers are seeing our beneficiaries, and they are, um, sending us claims. We are paying those. I can only We can only authorize and pay what's been submitted. I, I'm, I'm not trying to skirt around your question at all. So, um, I think. So we have room in the appropriation. So we have room in the appropriation, and I think that's what we're we're working through. I, I'll defer to Secretary Putnam. Right, but that, I think what we're looking at is the actual and that those are, those are based on claims submitted and so we do have room for that to increase, I think is what Director Deputy Mann is saying. Yeah, so, and I know that's a difficult thing. I, I know it's difficult and and I understand you're receiving these requests, but Is there anything we can do? We've got money, we've got a big problem. How can we manage this better? Can we increase reimbursements? Can we, I mean, is there anything we can do? We've got money available to solve the problem, and we have a very big problem. So how do we do that to, um, also, uh, present to y'all, we've, you know, with the committee that met on maternal health and made recommendations. Now the second part of those recommendations is working towards action items. The 1st, 2 of those action items were applying for this, um, transforming maternal health grant with CMS, which, um, was due September 20th, and so we, um, worked on that. with several partners, we are very hopeful. It's a 10 year, $17 million grant with technical assistance in addition to that, we have taken the steps internally, um, policy and programmatically and, and with the IT to then implement presumptive eligibility. Part of our big, one of the recommendations in that report, and one of the things that we have all talked about as committee members is working on prevention is how do we get more prenatal care. So that, um, pregnant moms can be treated as, um, As soon as possible. So presumptive eligibility by giving them 60 days as soon as they find out they're pregnant, to try to get them in to see a clinician, but also giving that clinician, the, um, the trust that that claim will be paid if they have a pending Medicaid application, presumptive eligibility is only, um, good for 60 days as, as federal guidance states, but during that time period, we want to work with, um, our partners in, um, DCO internally with DHS. And then externally with um external providers to get a full application done so that if the pregnant mom is eligible, she moves straight to Medicaid or if not, then how do we help her find other coverage. So I think those are some of the very first steps. One of the other, um, steps that we are taking, that is a work in process, is the payment structure. Um, I think we have all publicly recognized that Medicaid reimbursement in the maternal space is. is not always, um, it's not always good. So we are looking at different things to, um, to help. With that payment structure. We, we're just not ready to completely roll that out to be seen yet because we're looking at different models and different things. We are rapidly working on that and, and working with our partners to present that. We just, that's been the next step. I had, we had the grant presumptive eligibility, working with partners and then looking at the other recommendations that were made with that payment with that, um, maternal health committee. Uh, one more question. Um, the our Holmes was mentioned and I was deeply involved in that, along with some others when that was passed, I was chair of Public Health at that time. We had a monthly meetings, I believe, or quarterly before your time, but um, but that was, we thought that would be a game changer, and I think it will be, and, uh, but we just have not moved as fast as the senator mentioned a while ago. Uh, and I understand with the hospitals, you know, they've got a whole management structure. That they've got to work through. We have 2 large hospitals there in Jonesboro. I don't are either one of those working with this Saint Saint Bernard's has has signed that I think they were our first one to become a live 360 and then I think White River was the 2nd, and then, um, I believe, I can't, I can't say the third, I don't know that they've announced to me that was one of the things that came out of our homes was to do that, to, to send nurses out of the hospital, get longer coverage for the mothers and the babies. Um, but is there any way we can grow resources at that. I know you've got to wait on the hospitals because they've got their own business plan, uh, but is there any way we can throw more resources at that to move that faster because I think that's, that's probably the best thing we can do to solve this problem. So, um, our home still has their quarterly meetings and they're still open to the public. We would invite anyone to attend. We do those by Zoom now so that um that is not difficult for anyone to attend. We are measuring those metrics every year, and we do revise them regularly, so that we can see what is working and what is not working, and then as far as resources, um, we have, um, referenced that the the waiver will expire, um, on. 12:31 of 26, it will be, um, I think up for discussion in the legislative session of how expansion should look. And in that waiver approach, and I do think that will be the time period to answer about resources. Today I can't tell you exactly what resources are needed. I know I'm going to need some, but, um, I would like to get back with you on the specifics. I'd be happy to work with you on that. Thank you. Representative Painter, you recognize. Thank you, Mr. Chair. Um, good morning. I've got a question. Uh, it's on 5:50, uh, the, the child and family, uh, looks like the appropriation is 2.1 million, but in my big thick red book here going back 10 years. There's been no spending or anything. So, and then 23, 24 is 0. So I'm just ask, we just kind of want to know what that's used for. And if we haven't spent anything out of that in 10 years or more. We're trying to tighten our budgets. Why are we asking 2.1 million. Yes, sir. Um, this, it does get spent. This is a transfer annually to the hospital medical to to support the state's share of children's hospital UPL payment program. OK, so just, it does get spent, it doesn't look like it does. And, and that's been spent every single year. Yes, sir. It's an ongoing amount that is used to support state share. OK, great. I appreciate that. If you give me that information, I would greatly appreciate it. Yes sir. Thank you, Representative Beatty, you're recognized. Thank you, Mr. Chair. Uh, just kind of following back up on what Representative Ladyman was, um, discussing with the, um, Uh, the promised outcomes from our home, um, when do those meetings take place? And is it a set date and time every month that you have those meetings. It is quarterly, um, I don't know that it's a set, you know, every 3rd Wednesday of the quarter, but we can get you on the calendar if you're not currently getting those notices and, and that was my other question is, how are you sending notification out of those meetings? Are they showing on the, uh, on the legislative, um, calendar. I know they're posted to the DHS website, but we can make sure that they are cross-posted in additional areas and we can also send them to BLR staff for distribution. Mr. Chairman, a request that you could make of the agency on my behalf and members, uh, of a list of what's working under our home and the areas that are not working since they, uh, commented that they had that information. I think that would be beneficial to us. Thank you. I believe they can do that. Yes, sir, we can. secretary is affirming that. Thank you, sir. Thank you, Mr. Chairman. Center hammer you recognize. Thank you. One thing I wanted to know is, you know, we went through the um where everybody got dropped from Medicaid roll and then they were requalified or going through, where are we in the process of that? And do the numbers that you're presenting in your budget, uh, reflect a leveling off so that we have a pretty good snapshot of who's now been, uh, re-qualified. Thank you, Senator. I do want to make a clarifying comment that everybody did not get dropped. So, um, we, we did redetermination, but I just want to make sure that nobody thinks that everyone got dropped from, from the roles we we did yes sir thank you for that question. So the public health unwinding, um, occurred in 2023 from April 1 through 9:30, um, in response to an act by this body for us to do the redeterminations of the eligibles in 6 months. We were successful in doing that. Um, that is. Also thanks to Mary Franklin and her team, and lots of others. And so, yes, um, to answer your direct question, we, um, we feel that we have leveled off with the redeterminations. We do have, um, an average churn of about 20,000 beneficiaries every month. That is in that was um pre-pandemic and we quickly returned to 200 to 30,000, um, average on the monthly. And as of, um, November 1st, we had a approximately 861,000 Medicaid enrolled beneficiaries in the state of Arkansas. OK, so the bottom line is the numbers reflected in your budget reflect those that have gone through redetermination, not dropped off redetermination and, and so we're reflected there. Second question is, I want to go back to the nursing home quality, the long-term, uh, where it's, you know, it's, it shows 3000, but it's got a 4 million. I noticed in reading that says, uh, there's no gender revenue, the money's in the fund are civil penalties imposed by uh, uh, federal Centers for Medicaid, uh, CMS are those, those penalties that are assessed, are they returned to the federal government or are they returned into your budget somewhere. We have those in a fund. Did you happen to know what historically the average, uh, penalties are for that. And where, where would I find that number in your budget. So we have a report, I'd be happy to get that to you as, as I said, we only spend out of, um, that fund when we have those emergency situations, but we do take in periodic revenues, so I'll be happy to get that back to you. If you wouldn't mind, send it to, uh, staff and staff send it, I'd like to know. uh, what the historical collection is of those fees. And then the last thing is, going back to the drug discussion, I noticed also in reading, uh, that the rebates are, are they set and controlled by CMS and you have no input into the rebate program or help me on that. Yes, sir, rebates are, um, uh, accomplished at two levels. They are accomplished at the federal level, which those are set by CMS and then there's what is called supplemental rebates that is. That the direction of the state. So we have the option to add supplemental rebates. They're very proprietary and handled very delicately with, uh, legal and, um, pharmacy team and then we, once we put those into place, we can then collect on both sets of rebates. And as far as finding out historically, where's that reflected in your budget or how's that broken out to know what the rebates that the state has control over where's that number found in your budget? We, we track our rebates in total. Um, I'm, I may have to. I don't know that they're broken out, but we can try to find out. I'm turning to look at other staff to make sure we're answering that correctly. I'll tell you what, just let's, let's talk offline about that, not to take up the time in the committee and we get that number, please. Thank you. Mr. Chair. Representative Bentley, you recognize this to be the last question on this set of budgets. Thank you, sir, real quickly. Um, just, we've had 3 maternal boards shut down in Arkansas this past year and, um, we were told because they could not get The funding was not near enough for them to sustain, so are we gonna have to go through a rate review to, to get this, what they need. Do we have the information we need. We're not gonna have to go through a long, a lengthy process to do a rape review. That was my quick question. Um, we're probably, we're doing a modified rate review for them under the maternal health, um, committee structure recommendations. We have reached out to, um, hospitals and to clinicians about some of their current reimbursements, and we've already been looking at what our home pays on an average for their reimbursements to look at that payment structure. So no further questions. I have a motion for executive. I have a motion. I have 2. All those in favor, say ah, all opposed, I have it with that, we'll move on to uh, division of Provider Services, Miss Walls, you recognize. Thank you, Mr. Chair. The division of provider services and quality assurance is a preferent appropriation summaries on page 554 and fiscal year 25, it had total authorized appropriations of $21.6 million with 213 positions and 3 appropriations. The division is requesting total appropriations of 22.9 million in both fiscal years, which is an increase of 1.4 million with significant changes in one of their appropriations and that is the operations appropriation on page 559, which is funded through general revenue, federal. funds of various programs support, the division is requesting approximately $21.2 million in each year. The requested increases are combined 1.3 million in salary and matching and $177,000 in operating expenses. These increases are in support of the transfer of the placement of residential licensing unit to this division from the Division of Children and Family Services. We talked about this earlier. The division is also requesting a $111,000 decrease in conference fees and travel to align with current budgeted levels and the executive recommendation provides for the division. ' s requests apart from salary and matching, which they recommend increasing by a combined total of 950,000, which is a difference of 350,000, and that concludes my presentation for this division. See no questions. Do I have executive rec from Representative Meeks, I have a second? I have a second. All those in favor say aye. Opposed as habits. With that, we'll move on to the secretary office, Miss Wall as you recognize. Thank you, Mr. Chair. Uh, this department summary is on page 563 in fiscal year 25, this division has total authorized appropriations of approximately $86 million with 669 positions that are utilized across the department and for appropriations, the division is requesting a total appropriation of approximately 87.6 million of both fiscal years, which is an increase of $1.5 million with changes in one appropriate which is their operations appropriation. It is on page 569. Um, this is funded with general revenues, federal funds, and other sources that are determined primarily by the department's cost allocation plan. The division is requesting an appropriation of approximately $70.7 million in both fiscal years, which is an increase of 1.5 million. These requests include increases of a combined 1.9 million for salary and matching to 53.5 million and a $400,000 decrease in the professional fees line item in the executive provides for the division's request apart from salary and matching, which is recommended at a combined total increase of approx approximately 1 million, which is a difference of $900,000 and this concludes my presentation for this division. Thank you. I don't see any requests. I have a motion and I have 2 on in favor for exec rec. Post Passes, we are on to Uh, secretary's office. This walls Uh, we're on the division of youth services, Senator. OK, services, the division of you, uh, youth services, uh, appropriation summaries on page 573 in fiscal year 25, it has total authorized appropriations of $83.3 million with 122 positions and 5 appropriations. The division is requesting total appropriations of $83.2 million in both fiscal years, which is a decrease of $100,000 with changes in three of their appropriations. I'm gonna talk about first two changes together because they are related to one another. On pages 578 and 580 are the community services appropriation and the federal Child and use Service grants appropriation. These appropriations both provide funding for community-based programs to provide diversion services to prevent delinquency or entrance into the detention system. Community services is uh appropriation is funded through general revenues, Federal child new service grants is funded through um, sorry, community services general revenues, Federal Child and Youth Services. is funded through state or is surrendered through federal revenues and they're requesting that they transfer $5 million from community services, which is general new funded to Federal child and use service grants first that's federal revenue funded, um, in order to reduce reliance on reallocations of resources or miscellaneous federal grant requests in the interim, and the executive provides for the division's request and their final request for changes is on page 585. This is their operations appropriation. It's funded through general revenues, federal funds. and various program support Division is requesting increases of $45,000 in matching and $250,000 in professional fees. These increases, the women in professional fees is to provide for emergency medical services due to their increased population at the facilities. Um, they're also requesting decreases of $355,000 in operating expenses and $36,000 in conference fee and travel to better align with current budgeted levels. The executive provides for the division's request apart from the matching which they recommend increasing by. approximately $30,000 in each fiscal year, which is a difference of $15,000 and this concludes my presentations for this division and the department. Thank you, Ms. Walls. Uh, Madam Secretary, can you give us an update on the population that was mentioned is, is up. Yes, sir. So we currently as of today, we are, uh, continuing to see increased census. We have 345 as of today. Uh, the contract that we have for operating our residential services facilities is what's called, it's a firehouse model, so we have a, a floor, uh, that we consistently have to maintain at 244, uh, bed spaces available. Um, we are continuing to work with judges and probation officers and other community partners on improved release processes, um, and that has been helping us to manage and offset some of the increased census. Um, but we, um, you know, we, we are continuing to monitor that and we are currently planning to, um, Support the DYS services within our existing budget. Are, are these increases pretty much spread across multiple facilities or Uh, do, do we have facilities that are categorized for more serious cases getting more than others. It is all facilities, um, you know, we, we are monitoring across all facilities, you know, the ability to improve the release process, of course, you know, with extended juvenile jurisdiction, uh, you know, our older population at Dermot, we aren't able to do that as much. Um, but we are continuing to, and we, we have also, uh, worked with our diversion program, and we've also worked to open, reopen Lewis. So, um, again, with no additional funding, but to be able to redirect some of the senses so that we have more appropriate placement for our younger offenders. OK. Thank you, General Barry, you recognize? Thank you, Senator. So, uh, in this question may be for Mr. Crump if he was here today, but, uh, non-adjudicated youth. What are we doing for non-adjudicated youth now that, uh, the Youth Challenge program, uh, disbanded, uh, and. Did, did y'all absorb the, uh, The funding That was going to go to typically historically gone to you challenge, right? So, and, and we've gotten that question, um, so we have worked with the Department of Military Affairs to make sure that we're appropriate, we're able to offer CSTEP as a diversion, um, program, but they're very different programs as you're aware, you know, National Guard, it's a federal program, uh, youth Challenge is a federal program, and I will defer to Director Crump to provide some additional details on C-Step expansion. Well, and also CEP is an adjudicated program, correct? Whereas, uh, it's a residential for adjudicated youth, correct? I go and answer that. Thank you. Um, thank you for the question. We've actually CSTEP has both adjudicated and non-adjudicated, so it is used for some, some, some cases are Finn's cases, family in need of services. There are some that have been charged, but it's a diversion opportunity to hopefully prevent that youth from coming into DY's custody, and it just kind of depends on the court. They all kind of use their slots, those limited slots differently. OK, so for in, in the past, the, the children that have, uh, the troubled youth, I should say, uh, that have not gone through the judicial system. They're not adjudicated and a judge hasn't sent them there because they haven't committed a felony or anything, uh, or you're admitting tho, those children into the non-adjudicated program and is that a residential, uh, in, in residence type program. It is the CSTEP program, it's, it's a 100% residential. We have, uh, we're now offering 40 beds per cycle. We've gone up a little bit from 32, but yes, it's all residential. Our community-based providers also, um, assist with diversion efforts trying to um provide things for the courts like sanctions, electronic electronic monitoring, drug testing, you know, monitoring whether the youth's going to school, helping them get to appointments, so we had those community-based providers around the state as well, but our only residential program as far as those. non-addjudicated is the CSTEP program. So in one final question, the, uh, with youth challenge, you know, typically they had 100 kids. You know, they tried to recruit like 150, they would graduate 80 to 100. So it doesn't sound like you have the capacity to be able to, uh, provide for the needs of those troubled youth in a non-adjudicated environment. It's as the secretary said, it's a little bit different population. I know Youth Challenge was 16 and up. Um, it was primarily a voluntary, um, admission. There are some courts around the state I know that would find ways around that to give you in their court an opportunity to go to youth challenge. It's a 6, it was a 6 month program whereas ours is 8.5 weeks. Um, ours is 13 to 17 year old males. Youth challenge had both male and female, but you're correct, they would start with, I think, 150, 160 in hopes of graduating 100, and I, I think the goal was to recruit as well. I don't think it was that successful in recent years, but, um, it's a it was a little bit different program than ours. I do anticipate that those, those judges that were utilizing that program might be looking to us to help um with with Cep beds and we did add 8 beds. I think we're, this may be our 3rd cycle since we were able. add 8 additional beds. Yeah, and we, we just got to be careful not to forget about the those troubled youth and, uh, because there's a substantial number of them out there in the state of Arkansas and, and being able to provide services to those, uh, those children is, uh, incredibly valuable and to, uh, helping prevent them from being in that, uh, in the adjudicated program or incarceration. So thanks for taking my questions. Thank you, Mr. Chairman. Senator Hammer, you recognized for a quick one. The, um, The capacity out at, uh, Out of Alexander is, is what? What are they? What, what's their capacity supposed to be out there. Contractually, um, Senator, we're 120, there's 20 assessment beds and then 100 beds for treatment purposes. Uh, it's one of those questions when you, when I get asked, what is our capacity? There are things that we can do, uh, to be able to put more children there and we can take advantage of space. We've opened some space up for dorms that was previously storage, um, made some modifications there, but we've been as high as 200 youth in the last year. We're, I think we're back down to around 150, 10. 60 right now. So we're, we're getting back closer to that 120 that we're, we're aiming for at Alexander. OK, and in the budget related to the contract, uh, for right of passage in your budget, where is there an increase to accommodate because that was one discussion over the last couple of years. They were, they were maxed out. They were, some of that we blamed on COVID. We've had that discussion in the budget, is there any consideration for increasing the cost of their contract to accommodate for the additional. numbers or, or talk me through how that is resolved that if today they're at 165, but their contract is for this much. How we, how we addressing that in the budget? So under the current contract, um, it's set at the level where, where you see it. We don't have additional funding going to that contract, but that is where we are looking to, um, reallocate within our existing budget over the agency to make sure that we're able to cover the increase in census, but again, also working to uh expedite releases when that's appropriate and safe for the youth and the communities, um, and work on our relationship with the judges to do that. Yeah, and I know opening up other facilities has helped relieve some of the pressure. but as far as the, the, the cost of the contract and you having to take money out of other pockets. I'll call it of your budget in order to make up for that. Do you Should we look at just, and, and when's that contract up for negotiation, renegotiation. We just awarded it last year, so it is a new contract. It is a new contract and What's their rate increase to that contract. I don't remember. That's why I'm asking. There, there was a rate increase. I'll ask, um. 22 Uh, yes, Senator, there was a rate increase, uh, the, the daily rate increased to $320 per day. OK. So what you have to be moving money, do you think out of your budget in this next year? Is that something we need to be watching for because I'd rather just bite the bullet. Let's fix it instead of you having to rob from Peter to pay Paul, sort to say. We, we believe we have the resources within the existing budget to be able to address the need, um, again, using the other tools that we have to try to, um, level out where the populations are across the facilities. OK, we'll just, we'll watch it then. Thank you. Representative Shepherd, you recognize. Thank you very much and and thank you all very much for being here today. I have a couple of quick questions and one will follow up with Senator Hammer, um, how much is it approximately to house or keep one kid in state's custody for one year. I think I, I, the last figure I had was approximately a little over 100,000, maybe $130,000 a year. Is that accurate? One bed on the secure side of, of DYS is going to cost, I think around $117,000. I'm sorry, I didn't hear you. One bed, one occupied bed for a full year is going to be around $117,000. We also have, there's a, we, we do pay for off-site medical in their pharmacy separately so it might be a little bit higher than that, but that's, that's not a big. spend compared to that daily rate. So around $117,000 per year. That's what I was gonna ask if that include housing, food, education, medication, so if we included all of those components, it'd be probably over $120,000 a year to keep one kid in DYS's custody. OK, thanks. Thank you very much. The other question I kinda want to follow up with uh General Berry in addition to Senator Rice's question. in regards, well, Senator, I mean, General Berry first. You mentioned C Step and several of my colleagues here passionately expressed the void that would be there with the closure of Youth Challenge. Are we potentially looking at a situation where the courts may have to rely on DYS more because of that void that's now going to be there. And if so, will that have an impact on your budgets. So, we, we have been working with the courts through the transition, as I mentioned, um, and we have offered again, CSTEP and Youth Challenge are not apples to apples, as you're well aware, it's a, it's a very different type of programming for a different age and group of population. So where appropriate, we've been able to offer CSTEP. We've also, um, you know, I know military has worked with there are um. Youth challenge programs in neighboring states that had the ability to take some of the placements, and so that has been another option. Um, we also are relying on some of our community providers and our intensive in-home services for some of the diversion that is not there because of youth challenge. Uh, we, we have not seen a significant impact at this time because of that. Um, their, their senses had declined significantly as well, and that went into part of the decision making to close it. What was, what is the success rate of CSTEP. Approximately 80% of the youth that enter the CSTEP program, do not end up in DYS custody within that we tracked that for 3 years, um, once they complete the CSTEP program, so, um, I'd say it's an 80, 80% success rate. Last question, Mr. Chair, I apologize. Would it help if we looked at potentially increasing the number of beds, 4 seat step or is this part of the $5 million you all are asking for. So we, we've increased by 8 beds, and we, um, you know, we are intending to, as we're able to within the existing budget, continue the expansion that uh that we've indicated we want to do with CSTEP. OK. And my very last question, um, in regards to I I apologize. I, I apologize, but Senator Rice asked a question about the number of youth that are in custody today, so is Ajack budgeted for 120 beds, but we have 160 currently in custody today. That, that's correct. Right, thank you. That's correct, but they're paid a daily rate for every occupied bed. So they're being paid 4160 youth instead of 120. So it's just a matter of being able to have enough staff on site and have the bed the bed space and the other resources we need, but they are paid, so they're not capped at a at a certain level when it comes to payment. So that 160 is costing the division more than the 120 beds would. OK, thank you. And thank you Mr. Chair. Thank you. Send her love. Thank you, Mr. Chair. I'm gonna go back to General Berry and what he was asking because what I'm, I'm very concerned with the no adjudicated youth. I, I mean, I'm concerned with all the youth, but the nun adjudicated youth. And so, you said that I think in your testimony you said that that CS step also takes non-adjudicated youth. So, so what is your capacity for non-adjudicated youth. So it's it's sort of up to the courts since we only have 40 slots now up. From 32, um, when you divide that among 28 judicial districts for each cycle, that's not a lot. Most courts get one slot per cycle. Um, there are a few based on population to get to, and then if certain courts do not use their slot for that cycle, as we approach the start of a new cycle, we will offer those back, so we make an attempt to fill up and we never have a problem filling up those slots. So it's just up to the individual jurisdictions. Some jurisdictions might prefer to use those a little earlier in the process because, you know, when it comes to those at-risk youth, you kind of have prevention efforts that are really early before they get involved with juvenile justice then once they have been charged, there's a diversion effort to hopefully keep them from being adjudicated. And then there's also those youth who have been adjudicated that some courts will give the opportunity to come to DYA I mean to CSTEP rather than go to DYS custody. OK, so without, so let's go back to without the new challenge, I mean, are you all, are you all really making a contingency plan to ensure that we can take care of non adjudicated youth within C step. That's, I mean, because I know that we just discontinued CE. I, I, I'm I'm assuming that we could work with uh the the general brigadier general, uh, bridges to actually, I mean like what what are the steps that we're taking cause I, I'm, what I truly feel is I feel like we're gonna get to an issue and then it's gonna be a hole and then. There's gonna be youth to just go into the system because we just didn't have the mechanism to to take care of them, so, so we, we already, we were coordinating with General Stubbs before his departure for DC and we've been coordinating with General Bridges on that transition. And again, I, I do want to reiterate, um, part of the reason for closure was their, their numbers were down significantly and they were having challenges with staffing as well. Um, we have, you know, Cep when it is an option has been offered to judges as an alternative, um, but youth challenge again was mostly voluntary, um, and so you had a lower number of individuals who were choosing that as an alternative to whatever else the court was, was sentencing, um, I, I don't know if Director Crump wants to add anything to that. I will add that a lot of courts did not utilize youth challenge for some, some did, but a lot did not utilize youth Challenge for juvenile justice involved youth that were in their court because there are a lot of restrictions on you can't be your probation officer can't speak to you during those, those 6 months. You can't go. the court during those 6 months. So basically, but there were some that did. Some would find a way around it and basically give that youth an opportunity to, that's who's at risk, who's already been involved in the juvenile justice system are adjudicated, um, even if it was a low enough charge, that opportunity, it just depends on jurisdiction, and it happened so recently as the secretary said, you challenges numbers were down. I, I don't know yet what the fallout might be, um, because it's, it's only been what, a month or two? 2 or 3 months, I not not long since you challenges closed down. So any youth that would have had the opportunity to go through that and make it back to court and through the system. We, I, I've not seen that yet. OK. Well, let's take this conversation off the line, but I, that's, that is, it's a major concern of mine, so thank you, Mr. Chair. Senator Jessfield, you recognize. Thank you. Thank you, Mr. Chair and good morning again. uh Mi great concern, and I visited with Secretary about this. Uh, we met in her office, uh, Representative Shepherd and I about the age. That some of these children are being sent to juvenile assessment treatment center. We had one as young as 10 years old, and we said that one in our visit we indicated that one of the things is we need to work more with our judges so that they are aware of other places to send children rather than to be incarcerated. How is that going? I'll start in director Crump can certainly correct anything I get wrong. But um that is, so we're using in-home, intensive in-home services, um, more regularly with our community-based providers. We've leaned in on those services more so with our younger children. We've also provided for alternative placement for our younger children because of the concerns we had with placing them with older populations who may have more serious, um, offenses. And that's correct. We had a peak last fall. I, I think it's probably the period you're talking about, um, that we did have a large number of elementary school age children in our custody, um, we had to hire an extra teacher to be able to address that. We're down at this point. I think we have 1 or 2, 12. year olds are the only elementary school-ish age that we have in our custody, so it has dropped considerably since the fall, as the Secretary said. We started last fall, um, is when we were able to initiate the intensive in-home services as a preventative measure for the courts, so each jurisdiction is able to utilize a few of those to be able to go out and and have those individuals go into the home and start helping the family, connecting with services, be on call 24/7. So I, you know, it's never one of those things where in juvenile justice you can't always tie it exactly, but I, I think it's certainly possible that the increase with the intensive in-home services has helped with some of those. It's given those courts an option, and I've had very positive feedback from judges, uh, about that, using that resources are utilizing it now. They are. We are. You so much is left to the whims. Of each individual judge as to how they're going to approach it, but I'm, I'm happy to hear that our first resort is not going to be putting kids where they're in even more harm's way, even if they misbehave at 89 or 10. It's something really scary to me about putting them with 16 and 17 year old kids. Thank you so much. Thank you, Mr. Chief. To have a motion for executive Rick, I have a motion. Do I have a second? All those in favor, say aye. I post. I have it. Members, as we move on down to the agenda, we get to item D, D, DFNA You guys are dismissed. Thank y'all. I, I will say that out of my years of being in the budget hearings, I want to say thank you for moving those appropriations closer to the spending levels. That is something that's been pushed for, and I commend you for actually doing it. You're one of the first agencies to do that. So thank y'all. We had great support from DFNA in the governor's office and our team has done a phenomenal job in helping with those projections. Thank you. And if you would hold on one second, send, uh, Representative Fight, you're recognized for that personal privilege. Thank you, Mr. Chair. I wanted to, uh, take a point of personal privilege and thank you for your efforts. November is National Adoption Month, and I really to what I believe is now historically the lowest, the fewest children now awaiting adoption in the state of Arkansas. These are the children who have already been cleared for adoption, parental rights have been terminated voluntarily or through the court, and you are attention to these children on social media and through events and other happenings and uh we're seeing great success with these children being adopted and thank you for those efforts. Thank you. Great team effort. Thank you. Thank you guys. With that members will move on to the Arkansas Children's Hospital DFNA dispersing, um, Senator Ervin is putting a flag on that with that, do I have a motion for executive Rick? Of motion of 2, all those in favor, say ah. All opposed. Looking ahead at the nursing board is held is one of the held items as well. It has no change orders outside of personnel, which have already been approved. Do I have a motion for executive direct as well. A motion of 2, I second. All those in favor say aye. All those opposed. I have it. So members with that will be moving on to the AOC executive Committee, 5 minutes upon adjournment, and then ALC Pier will meet upon adjournment of the ALC executive Committee, November 21st at 9 a.m. will be the last budget, uh, hearing, and it will be the governor's balanced budget presentation. Seeing no other business, we stand adjourned.