House Public Health, Welfare and Labor Committee

February 14, 2023

Rep L Johnson: Chair sees a quorum. Sorry, Chair got to talking too long and didn’t see the time before he saw a quorum. Apologize for the late start. Yes, so before we get started, Representative Ladyman, you’re recognized.

Rep Ladyman: Thank you, Mr. Chairman, a point of personal privilege. Members, I’d like to introduce Meredith Stanley. Meredith, would you stand up, please? Meredith is from the Academies of Jonesboro High School, and she’s shadowing me today. She’s actually part of the Active Citizens Club there at JHS, and they’ll be paging for us today. So, Meredith, welcome.

Rep L Johnson: Thank you. It’s great to have you here. We love the fact you’re willing to come and participate and you’ve got a great Representative to shadow today. Representative McGrew, are you in the room? Are you ready to present your bill? This will be House Bill 1360.

Rep McGrew: Thank you, Mr. Chairman. Yes, House Bill 1360 is– what the bill does, currently under the definitions of electrical, there’s two different classifications. There’s commercial classifications for electrical journeyman and master, and a residential. And on the residential, currently, it says that you can wire a single-family dwelling or duplex. What this bill does is add to that definition triplex and quadruplex.

So currently, this residential wireman can wire a duplex. If you put a new duplex beside it and connect them with the roof, it’s a fourplex and so it kept them from doing that. And that happened to someone who contacted me. It’s a pretty simple bill, it just adds that triplex and quadruplex. I’ve run it by the chief electrical inspector, he was fine with it. And the attorney for the Licensing Board asked me to add a little verbiage in there at the end of the bill which says it’s for residential only, and that’s all it does. I’m free for questions.

Rep L Johnson: Members, do you have any questions for Representative McGrew? Representative Allen, you’re recognized for a question.

Rep Allen: Thank you, Mr. Chairman. I want to make sure I have a clear understanding. So your bill is not changing any existing requirements or laws that’s out there right now. You’re just adding to it, is that correct?

Rep McGrew: Yes, sir. And it’s really not even adding to it. It’s just clearing up the definition in the code that says that residential journeymen could do single-family and duplexes and it adds triplex and quadruplex. It doesn’t affect any of the other code or any other requirements anywhere.

Rep Allen: Okay. Thank you.

Rep L Johnson: Any other questions from Committee? Anyone here signed up to speak for or against the bill? Seeing no one. Representing Womack?

Rep Womack: I have a motion do pass.

Rep L Johnson: We have a motion do pass. Any discussion on the motion? All those in favor say aye. Opposed? Congratulations, Representative McGrew, you’ve passed your bill.

Rep McGrew: Thank you very much. Thank you, Committee.

Rep L Johnson: Members, we’re going to pass over House Bill 1385, it’s Representative Vaught’s bill. And we’re going to go on to the Senate bill, Senate Bill 187. Representative Schulz, are you prepared to help present that bill? Thank you.

Rep Schulz: Good morning, colleagues. Mr. Mark White is going to help me present these bills, as I’ve known I was going to present them for about 10 minutes.

Rep L Johnson: You’re doing great, Representative Schulz.

Rep Schulz: Which one are we going to start on Mr. Chair?

Rep L Johnson: Let’s start on 187.

Rep Schulz: Okay. This bill repeals an Advisory Committee that is no longer active. That’s all that it does. It’s pretty simple.

Rep L Johnson: Any questions for the Committee about this bill? Seeing no questions. Anyone here to speak for or against the bill? Seeing none, Representative Schulz, are you closed for your bill?

Rep Schulz: Closed. Make a motion do pass.

Rep L Johnson: We have a motion do pass. Any discussion on the motion? All those in favor say aye. Opposed? Seeing none, Representative Schulz, you’re recognized to present Senate Bill 188.

Rep Schulz: Colleagues, this is a bill just for clarification. In 2017 the legislature combined two DHS divisions to create the division of Aging, Adult, and Behavioral Health Services. Since then, DHS discovered three code sections dealing with provider licensure where a code section was amended with the wrong division name. This bill is simply a technical correction.

Rep L Johnson: Any questions from Committee? Representative Ladyman, you’re recognized for a question.

Rep Ladyman: Thank you, Mr. Chairman. Can you give us some background on why they combined those? I mean, is there any other good reasons?

White (DHS): Mark White, Department of Human Services. So this was back in 2017 when you all approved legislation to combine the division of Aging Adult Services and the division of Behavioral Health Services to create one combined division to oversee all aging and behavioral health services. I think thinking at the time was that there’s a lot of overlap between those areas, they both involve working around Medicaid waivers, as well as non-Medicaid spending going out into the community. And so the thought was to combine some of that expertise on those two divisions.

And so that’s where it is now. It’s just the only issue was, in these three instances in the code it should have referred to our Division of Provider Services and Quality Assurance because that’s the division that oversees provider licensure and certification. And that’s what these three sections are talking about.

Rep Ladyman: Thank you.

Rep L Johnson: Any other questions from the Committee? Seeing none. Anyone here to speak for or against the bill? Seeing no one, Representative Schulz, are you closed for your bill?

Rep Schulz: I’m closed. Make a motion do pass.

Rep L Johnson: I have a motion to pass, any discussion on the motion? Seeing none, all those in favor say aye. Opposed? Congratulations, Representative Schulz, well done. You passed your bill. 

Rep Schulz: Thank you.

Rep L Johnson: Members, I’m actually waiting on an amendment to House Bill 1128. It may be a few more minutes before it’s over here. Fully on me not having the amendment here in time. If I could lean on the Committee maybe we could recess for five minutes and then we’ll come back in. So we’ll go into recess. I guess I have to gavel us out for a moment. No, just recess? I like to use the gavel, are you sure? We’ll recess for five minutes. As soon as I have that amendment I’ll call us back in order. Thank you, all. I appreciate that.

[Recess]

Rep L Johnson:Representative Lee Johnson District 47.

Rep Miller: Go ahead, you’re recognized.

Rep L Johnson: So the amendment you have before you changes one word. It changes the word certified to licensed. That’s just my mistake when I drafted the bill. License is consistent with the other language that we use for other licensees and so that’s the more appropriate word than certified. This came from the Department of Health, they were asking for this change. And I’d be happy to take any questions on the change.

Rep Miller: Any questions from the Committee? Do we have a motion?

Rep L Johnson: I’ll make a motion do pass on the amendment.

Rep Miller: Have a motion do pass. All in favor say aye. Any opposed? Go ahead with your bill.

Rep L Johnson: Thank you. So, members, Emergency Medical Responder is a certification licensure that can be obtained nationally. It’s been around for a long time. It’s a relatively short course, it’s about a 40-hour course that people can take. Many people in the state take this already. It’s offered through the Fire Training Academy. Lots of our volunteer firemen have been certified as Emergency Medical Responders but we as a state have never recognized that licensure. All this bill does is enable the Department of Health to recognize that as a licensure. 

It’s voluntary. It doesn’t mandate that any first responder become licensed as an Emergency Medical Responder. It just creates that pathway for recognition for those people that have taken the test or want to take the test to become licensed in our state. And I’d be happy to answer any questions.

Rep Miller: Are there any questions from the Committee? Representative Richardson, you’re recognized.

Rep S Richardson: Thank you, Mr. Chair. So my question is, is there a fee that’s associated with this licensure?

Rep L Johnson: So where this goes in statute, there’s already a fee structure in place there for collecting for people that are registering as EMTs or paramedics. So it’ll be incorporated in that fee structure is my understanding from talking to the Department of Health. So it won’t be a new fee, it’s a fee already in place that this will be layered into.

Rep Miller: You’re recognized for a follow-up.

Rep S Richardson: So these individuals currently, if they receive this certification licensure, from a national perspective, they do not have to pay this fee but if we pass this legislation they would be required to pay this fee?

Rep L Johnson: If they want to be recognized and licensed. There’s no mandate that would require them to be licensed if they want to take the test and just have a national licensure. But if they want to be recognized in the State of Arkansas as an EMR, then yes, that fee would be necessary to keep their licensure on file with the Department of Health.

Rep S Richardson: Thank you.

Rep Miller: Representative Gonzales?

Rep Gonzales: How did this differ from other emergency medical responders?

Rep L Johnson: So right now, a first responder doesn’t require any training necessarily. You can just you– you’re part of a volunteer department.

Rep Gonzales: Can I clarify my question? 

Rep L Johnson: Yeah. 

Rep Gonzales: So you said it’s going in the same code section as EMTs and paramedics and that. So how do they differ from this?

Rep L Johnson: So EMT is about a six-week course is my understanding of how long it takes to become EMT certified. There’s training involved with that. There’s more training involved with becoming an EMT than being EMR licensed or certified. So this is something between. I’ve not got any certification or training at all and EMT. So as the layers would go it would be your EMR, EMT, EMT Advanced, Paramedic as the training progresses through. So this is a very entry-level training with the very basic exposure to medical knowledge and skills.

Rep Miller: Representative Ferguson, you’re recognized.

Rep K Ferguson: Thank you, Mr. Chair. Representative Johnson, quick question. In the city of Pine Bluff, our fire department has I believe volunteer medical responders. And in this bill, it says that they can be reimbursed through the Medicaid Program or by an insurance company if they are performing their duties. So if I have an incident at my home, and they come and resuscitate somebody, then we can file it on our insurance?

Rep L Johnson: Correct, with DHS, correct. It creates a reimbursement process.

Rep Ferguson: Just with Medicaid not with?

Rep L Johnson: I’m going to lean back but I think it creates a reimbursement pathway for all insurers but certainly through DHS, yeah. Right now there’s no way to reimburse for that service through EMR because we don’t recognize that certification. This allows that pathway to be created for that to happen.

Rep K Ferguson: Okay, through Medicaid but we are not sure whether they can do it the insurance?

Rep L Johnson: I would have to look at it closer. I don’t know for sure that I can answer that question specifically right now.

Rep K Ferguson: Okay. All right. Thank you.

Rep Miller: Any other questions from the Committee? Representative Gonzales?

Rep Gonzales: Thank you, Mr. Chair. So the bill says that they may be reimbursed by Medicaid program and an insurance company. Are we going to mandate that they are reimbursed or is this?

Rep L Johnson: That’s not my intent. My intent with the bill is to create the pathway, right? I mean, I think my intent with the bill is to take this national recognition, certification, licensure, and bring it to the State of Arkansas. It feels like it would follow over time that once we recognize the certification we would look to try to reimburse for those services.

Rep Gonzales: Okay. And I’m still trying to figure out where this licensure is going to fit in, what the role is going to be because like Representative Ferguson, I’ve got a lot of volunteer fire departments, a lot of volunteer first responders. I mean, they volunteer to get out there and help in these medical situations. And what I don’t want to see is it lead to requiring those people to have to go get extra training and become this licensed medical responder, I definitely don’t want to see that. So I’m trying to see where they fit in between just the volunteers and the paid EMTs, paramedics.

Rep L Johnson: Or the career fire departments. And I’ve heard that feedback from different people. Certainly, my intent is to keep this voluntary. But there are services that aren’t necessarily volunteer that would like to have their first responders trained and recognized for that training. So the idea for me in creating this was to provide that pathway for the entities that are looking to have this as part of their service but not require it for any of our volunteer services in any way.

I agree with you, I think that we have enough trouble recruiting volunteers. I don’t want to create a pathway where people are like look , if I have to take this test I’m not going to show up and volunteer. But at the same time, I think it’s fair and reasonable for the EMS services and the career fire departments that are looking to have this training or maybe are already doing this training and just not receiving credit for it, to be able to look for that pathway to hopefully at some point provide some reimbursement for the services they’re rendering.

Rep Gonzales: Okay. Thank you.

Rep Miller: Any other questions? All right, is there anybody signed up to speak for or against the bill? Would you like to close?

Rep L Johnson: I’m closed for my bill, make a motion do pass.

Rep Miller: As amended?

Rep L Johnson: As amended, yes.

Rep Miller: All right. Everybody in favor say aye. Any oppose? All right, congratulations, you have passed your bill.

Rep L Johnson: Thank you.

Members, I don’t think there’s anything else on the agenda today. I appreciate everyone’s patience with the way the agenda looks. I’m trying to work with staff to try to keep it organized in a way that makes sense. There are a number of bills that are pending fiscal impact still. Right now some of the ones that are pending fiscal impact on special order, I’m going to try to just move those under fiscal impact for clarity’s sake. There are a few bills that are specifically I know going to be on for special order, House Bill 1301, House Bill 1234, House Bill 1189. Those bills will be on for special order to date. I’m just waiting on members to work with the parties involved to come up with a date that makes sense for them and for us.

The other ones waiting on fiscal impact, as soon as we have those fiscal impacts back I will let members know. And if you have a bill that’s on the deferred list, happy to move that up from deferred, just come and let me know when you’re ready to run it and we’ll run it. Are there any questions about the agenda or what we’re trying to do there?

I do anticipate having another informational only meeting next Tuesday the 21st. I’m hoping to have some people come to address healthcare workforce issues, hear from a variety of people on that topic. We’ll try to have it upon adjournment if that makes sense for everybody. Hopefully, we’ll have that as a joint meeting with the Senate again, and we’ll try to have that over in Big Mac so there’s plenty of room. And hopefully, some good dialogue and questions. If something changes with that I’ll let everybody know.

Any other questions from Committee or discussion on any topics? All right, seeing none, meeting adjourned.