Senate Committee on Public Health

February 15, 2023

Sen Irvin: Thank you all for waiting. Calling the Public Health Committee meeting to order. As we’re beginning, today is Alzheimer’s and Dementia Advocacy Day. And so I’ve asked for them just to give us a little presentation about what they’re here today to do. And if you’ll come to the table and just– he brought flowers and so I love flowers. And I wanted him to speak about the flowers and just give us the ability to recognize what they’re trying to do today. So if you’ll state your name for the record, you’re recognized.

Cook (AA): David Cook, Senior Public Policy Manager for the Alzheimer’s Association. I did bring flowers. Will you accept this rose I guess is the phrase we use.

Sen Irvin: I will.

Cook (AA): This afternoon we are at 11:30 in the Rotunda. We will be meeting for a special ceremony to honor the 60,000 Arkansans who are currently living with Alzheimer’s or other forms of dementia. We do have several different flowers that we are asking lawmakers to come and hold depending on your connection to the disease.

So I want to just share briefly what these flowers represent. The purple flower is representative of someone that you’ve lost to Alzheimer’s. I lost my grandmother to Alzheimer’s, so this is one of the flowers that I carry. So if you have someone in your family or someone you know that you’ve lost to Alzheimer’s or another form of dementia, the purple flower is for you.

The blue flower represents individuals who are living with Alzheimer’s or a dementia diagnosis. And so we have several, my father who’s actually here today  who’s living with vascular dementia. And we have several advocates who have Alzheimer’s and dementia.

The yellow flower represents if you’re a caregiver of someone with Alzheimer’s and dementia. Here in Arkansas, we have over 93,000 caregivers that provide unpaid care to individuals living with Alzheimer’s or another form of dementia. The value of the care that they provide is a cost savings of close to $2.1 billion to the state. So our family caregivers play a critical role in providing care for their family members.

And then the orange flower, last but not least, is the flower we hold if you’re just a supporter of the cause. And as you make your way into the Rotunda, on the right-hand side there is a table staged with all these flowers. So we encourage you to pick one up and join us for our ceremony at 11:30. And then our advocates will be on the Senate floor and the House floor today as well– or in the gallery, not on the floor.

Sen Irvin: Thank you. Thank you so much. We really appreciate what you do. And again, welcome. Parents, it’s great to see you but I appreciate what you do and making sure that we have attention to that. If you’ll stay at the end of the table, Senator Boyd, if you will run their bill for them that would be great. Members, we’re just going to skip around since we’re going to just take care of this one right at the top of the agenda. It is House Bill 1166.

Sen Boyd: Thank you, Madam Chair. So House Bill 1166 is an act to add an additional member to the Alzheimer’s Disease and Dementia Advisory Council. And I’m going to turn it over to our friend here.

Sen Irvin: Thank you.

Cook (AA): Thank you, Senator Boyd. In 2021, this body with unanimous approval established an Alzheimer’s and Dementia Advisory Council. The council has been working actively to update the Alzheimer’s state plan. Arkansas was one of the first states in the country to have an Alzheimer’s disease plan that they published in 2011. Unfortunately, nothing has– several of the recommendations listed in the first state plan were implemented. One of the recommendations was the Silver Alert program which we have now here in the state. But the state plan had not been updated since 2011, so prior to having legislative authority we met independently to begin the process of updating the state plan. In October of 2022, this Council updated the Alzheimer’s state plan. So we have an active state plan and we are working to implement pieces of that plan.

What we recognize is on the Council we did not have representation from home care providers or assisted living organizations. So we are adding the Arkansas Residential Assisted Living Association, whose Executive Director is Phyllis Bell. And then the Arkansas Home Care Services Association to fill those gaps and they work for home care providers, both skilled and unskilled. So this bill is just a little bill that doesn’t do much, just adds those two members to the Council. Happy to take any questions.

Sen Irvin: Members, do you have any questions? Seeing no questions, is there anyone here to speak for or against the bill? Seeing none, you can close for your bill.

Sen Boyd: Thank you, Madam Chair. I’m closed for the bill and I appreciate a good vote and make a motion do pass.

Sen Irvin: Motion do pass, second. All those in favor say aye. And opposed? Ayes have it. Congratulations, you’ve passed your bill. Thank you so much. All right, moving down, Senator Ben Gilmore, come on down. You are here for House Bill 1197.

Sen Gilmore: I am. Thank you, Madam Chair. Senator Gilmore, District 1. This bill is– I hate to use it’s a pretty easy simple bill but it really is. A lot of it is it codifies some practice that’s already in place with unemployment assistance. This got wide support in the House, it’s an agreed-to bill. We’ve actually made an amendment to calm some of the concerns from private sector, as well as worked with DWS.

So as you may or may not be aware, there is a reporting system in place for those who are seeking or looking for work but are on assistance that are getting UI benefits. And basically, the goal is that they’re looking for work, they’re actively seeking work, and that they’re not leaving potential employers in the lurch. And so what we’re seeing, in fact, I think it was the Washington Post actually reported on this pre-pandemic but it actually was made worse during the pandemic that people were just not showing up for interviews and other things.

So this is a bill to incentivize them showing up and allows the employer to report if they don’t show up for that interview or for that appointment or anything like that. And so if they don’t and the employer reports that they don’t, they’re potentially at loss of losing a week of unemployment benefit. So with that, this bill is simply to incentivize work. We need more people in the workforce. And it codifies some practice that’s already in place with the reporting system. And hopefully, we will see people take advantage of the work opportunities out there and build our workforce. So with that, I’m happy to take any questions from the Committee as best I can.

Sen Irvin: Okay. Senator Love, you’re recognized for a question.

Sen Love: Thank you, Madam Chair. And Senator Gilmore, so with DWS if I guess the person receiving UI benefits would contact them I guess with the people that they’ve been searching for jobs, right?

Sen Gilmore: Mm-hmm.

Sen Love: Okay. And then I guess I’m trying to think about how this bill would actually– how it actually works, the mechanics of it.

Sen Gilmore: Sure. Well, I think it’s pretty simple. So if they are looking for work, they have an interview that’s scheduled and they don’t show up for that interview, then the employer has the opportunity to report that and say hey, these individuals didn’t show up. Now, within the bill and also over at DWS, there is language to make sure look, if your child is sick or something comes up and you have a legitimate reason as to why you couldn’t show up for that appointment, then you have an exception there. And so because again we don’t want people to lose a benefit that they actually may need just simply due to some technical issue. And so those protections are in place with this bill. And I think it clearly defines that with what DWS is doing and making sure that we’re not being punitive when we don’t need to be punitive.

Sen Love: Okay, so does DWS– what I’m trying to get at is does DWS have I guess the staff? When their staff is working the case, they’re in contact with that employer?

Sen Gilmore: Yes.

Sen Love: I’m just trying to figure out how it works.

Sen Gilmore: Yeah, absolutely that’s a great question. So absolutely, right now the employer and DWS staff do talk. There is a portal in place so that they can report and then that is checked. And so one of the amendments that we made to the bill just to help calm some concerns from the industry side, was that we changed a shall to a may. So it is voluntary from the employer side, therefore, it’s arguably voluntary from the DWS side because there’s no required punitive action because of that one word change from shall to may.

Sen Love: Okay. Well, I think I have mixed feelings about the bill but I do understand because as I read the bill and you used the word ghosting. I kind of like that. When I was actually hiring for the pandemic I had a few people ghost me. I guess that’s what you would call it. So okay, all right, I just want to know the mechanics of the bill. Thank you.

Sen Gilmore: Thank you for the questions.

Sen Irvin: Are there any other questions from members of the Committee? I do have a question actually, the term ghosting. So I understand I’ve only heard it primarily when in a relationship if somebody ghosts you they just aren’t interested in you anymore. But I mean on a serious note is that term defined and is it defined in state statute?

Sen Gilmore: That term is not. It’s in the title of the bill in quotes just to help sort of identify what we’re trying to do here. If you talk to employers, which I’m sure many of y’all have, that have talked to employers that have said hey, I’ve responded to people, set up a time. They respond back. Then they don’t show up and I text them or I call them and I get no response. Obviously, that’s a form of ghosting and it’s more in a relationship sense. I would argue that an employment opportunity is sort of building a relationship with an employer. So the term’s not defined and again it’s not in the statute, it’s in the title and in quotes just sort of lending an idea of what we’re doing.

Sen Irvin: Okay, lending color.

Sen Gilmore: Lending color if you will.

Sen Irvin: Okay. Well, I just wanted to just make sure that it wasn’t necessary for us to define it.

Sen Gilmore: No. And DWS didn’t think it was.

Sen Irvin: Okay. Thank you, that was my question. All right, any other questions from members of the Committee? Anyone here wish to speak for or against this bill? Seeing none.

Sen Gilmore: I’m closed.

Sen Irvin: You’re closed? All right, what is– motion do pass, second. All those in favor say aye. And opposed? Ayes have it. Congratulations, you have passed your bill and we have not ghosted you. Okay. Let’s see, Pilkington is not here. Senator Wallace, do you want to run HB 1076? I have the first three bills that I will run but I will defer to you, Senator Wallace.

Sen Wallace: Madam Chair.

Sen Irvin: Yes, sir.

Sen Wallace: Senator Dave Wallace, District 19. This is pretty much a cleanup bill and it clarifies the language that one vehicle is included in the annual permit fee. It clarifies that an owner is charged for each septic tank pump truck. So his first truck is $25, second truck’s another $25, and on and on and so forth. There’s no increase in the license fee. And the bill clarifies that the license is for the individual and that the vehicles have a permit, that’s the $25 I was talking about. Pretty much not a fee increase, it just clarifies what the standard practice is now in the industry. There’s approximately 200 licensed septic tank cleaners in Arkansas and again, a business may have as many trucks as they wish, most have one or two. And with that, I stand by for your questions.

Sen Irvin: Are there any questions from members of the Committee? Seeing none, is there anyone here to speak for or against this bill? Seeing none, you can close for your bill. And motion do pass, second. All those in favor say aye. And opposed? Ayes have it, congratulations, you’ve passed your bill. Okay, members, I am going to run Senate Bill 186, 213, and 212. Senator Flippo, will you take the Chair please?

Sen Flippo: Thank you, Senator Irvin. And if you’ll introduce yourself you’ll be recognized to proceed with your bill.

Sen Irvin: Thank you. Senator Missy Irvin, District 24. I have with me Mark White with DHS. We will start with Senate Bill 186, which I believe does have an amendment.

Sen Flippo: Yes, ma’am. And I guess staff is passing out that, members, real quickly.

Sen Irvin: The amendment addresses the main concern expressed by providers by changing language to remove confusion about drug testing requirements that already exists in the current law. That’s the purpose of the amendment. I’ll make a motion to adopt the amendment.

Sen Flippo: All right, we’ve got a motion, and a second by Senator Boyd. All in favor say aye. Opposed? Congratulations, the amendments been adopted.

Sen Irvin: Thank you. And members, the purpose of this bill is to clarify the requirements for background checks for workers who provide hands-on direct care to clients with intellectual or developmental disabilities or who have access to those clients’ properties. Current law has a patchwork of background check requirements for different types of IDD direct care workers, which creates some confusion and inconsistency. And so this bill aims to address that so that it creates a single uniform approach for the staff who work with IDD clients.

So specifically it requires that those workers, before a worker is hired to work with an IDD client, they must be compliant with a criminal history check, sex offender registry check, adult and child abuse registry checks, and drug screen. Most of our providers in intellectual developmental disability providers are already performing these checks but what this bill does is just brings uniformity to that process in kind of an across-the-board approach so there’s no loopholes or gaps.

Sen Flippo: Are there any questions from members? All right, seeing no questions. Is there anybody signed up to speak for or against this bill, no? Okay, Senator Irvin, you’re recognized to close to your bill.

Sen Irvin: I close for my bill. Thank you.

Sen Flippo: All right, members. I’ve got a motion from Senator Boyd.

Sen Irvin: Second.

Sen Flippo: Second from Senator Irvin. All in favor please say aye. Opposed? Congratulations, Senator, your bill passes.

Sen Irvin: Thank you.

Sen Flippo: Oh, do pass as amended, my apologies.

Sen Irvin: Yes. As amended, thank you.

Sen Flippo: And then next up you’re going to be running Senate Bill 213.

Sen Irvin: Yes, we can do 213. Okay, Senate Bill 213, the purpose of this bill is to ensure that a provider who employs a direct care worker and any agency that licenses the worker can be notified of a screened-out allegation of adult maltreatment. When these allegations are made and reported to the hotline, that allegation can be screened out for a variety of reasons. And I’m going to let Mark White actually speak more specifically about how this screened-out process works.

White (DHS): Thank you, Senator. Mark White, DHS. So when we receive a call on the adult abuse hotline we have to review that information and determine if all the information they’re giving us is true, does that represent adult maltreatment? And there are several situations in which they may give us information but we have to screen that complaint out because it doesn’t meet the legal definition. One of the common reasons is if it’s an incident that happens out of state. In that case, we’ll refer it to that other state’s hotline but for our purposes, we have to screen it out.

And then there are some cases where there is behavior that may be bad behavior. It may be some behavior that we don’t like but it doesn’t necessarily meet that legal definition of adult maltreatment. And so the issue here is that employers, if they have an allegation made against their employee for employers who deal with adults, they have to report that to the abuse hotline. When they report that to us and we screen it out, under current law we can’t tell them we’ve screened it out. And so that leaves the employer in limbo because they know they’ve given a report on their employee, they may even know that it’s not true but they don’t have no way of knowing is that going to be investigated or not, what is DHS going to do with it. The express purpose of this bill is to allow us to tell the employer that yes, we have screened this out so that the employer knows and they can take whatever actions they want to around that employee.

Sen Flippo: All right, members, are any questions from members of the Committee? All right, seeing no questions. Is there anybody signed up to speak for or against this bill? All right, seeing nobody, Senator Irvin, you’re recognized to close for your bill.

Sen Irvin: I am closed for the bill. Appreciate the work with the long-term care industry and DHS. This is important for their systems to work and their employees. Thank you.

Sen Flippo: Got a motion from Senator Boyd, second from Senator Irvin. All in favor please say aye. Opposed? Congratulations, Senator, your bill passes.

Sen Irvin: Thank you.

Sen Flippo: And then I guess next up you’re going to be doing Senate Bill 212?

Sen Irvin: Yes.

Sen Flippo: Okay.

Sen Irvin: Senate Bill 212, so this is just simple, it just eliminates a requirement for a notary. These are moving to an online basis, so notary is not required.

Sen Flippo: Okay. All right, members, are there any questions from the Committee? All right, seeing nobody. Any questions, or anybody sign up to speak for or against the bill? All right, seeing nobody signed up, Senator Irvin, you’re recognized for close of your bill.

Sen Irvin: Close, motion do pass.

Sen Flippo: Got a motion, second. All in favor please say aye. Opposed? Congratulations, Senator, your bill passes.

Sen Irvin: Thank you. Thank you, Senator Flippo, for Chairing. Thank you, Mr. White.

Sen Flippo: Thank you.

Sen Irvin: Okay, are there any other members that are here to run bills or seeing none? Okay, members, before we adjourn the meeting just to note I want to speak to this for everybody to hear and understand. We are awaiting Medicaid fiscal impact statements, fiscal impact statements with Medicaid. The reason why is because we are working to ensure that Medicaid is operating at a budget neutral. Okay, that is going to be a tough thing for Medicaid to operate at budget neutral but we’ve got to understand the legislation and how it’s going to affect Medicaid and it’s important for us to be pragmatic and prudent in that approach.

So those bills are held for that reason so that we understand the complete impact of what an education bill is going to look like financially for the State of Arkansas and the taxpayers. As well as a criminal justice bill that we know that is in the works, which is also going to cost a lot of money, and tax cuts that are being proposed. So with that, it is important and prudent for us to do our due diligence on any legislation that’s going to affect Medicaid and increase spending. 

We have to understand that before we decide that we’re going to vote for a piece of legislation that would do that. And so we just need to know all the consequences of what those fiscal impact statements will be. So there are some that may just be a wash and neutral and there are some that may have a greater impact but we’re just trying to treat them all the same. Do you have a question?

Sen King: I do but you know we put too much reliances in these fiscal impacts and these things. I’ll go back to 2013, the other bills that’s involved with Medicaid down here that we were going to save all this money and the complete opposite happened. We did not save money by passing Medicaid expansion. I mean, I’m not getting in the debate of doing away with the program all that but I’m just saying, I have been down here so long that I’ve seen all these predictions. And the one thing that is uniform about them – and I’m not questioning anything about who’s doing this now – is that number one, they’re wrong.

So when we put reliance on these things – I’m just making a statement because I can back it up – we’re putting all these things and we were going to save money in Medicaid expansion. We did this Medicaid reform task force thing they came up with, there was nothing saved in those things. We did not save any money in Medicaid and spend less. So I just want to make the comment that all these things that come up and everything, the reliance in them should be questioned.

Sen Irvin: I’ll invite you to go and sit down with the folks at DMS and DHS and go through the numbers with them personally. Thank you, any other questions? Senator Boyd?

Sen King: Well, I sat down with DHS and all that before and it still– 

Sen Irvin: Senator Boyd?

Sen Boyd: Before you go may I make a disclosure to the Committee?

Sen Irvin: Yes.

Sen Boyd: Okay. So I just wanted to disclose to the Committee in case anyone does not know, that I am an Arkansas licensed pharmacist.

Sen Irvin: Yes, I’m so sorry.

Sen Boyd: No it’s fine.

Sen Irvin: I forgot to do that.

Sen Boyd: And that I do have ownership in two pharmacies in the State of Arkansas. And my wife is an audiologist licensed in the State of Arkansas. And I just want to make sure before we start hearing legislation that might impact any of that, that I’ve disclosed to the Committee that. Thank you.

Sen Irvin: Thank you. And we will and I appreciate that. And thank you for reminding me to do that. If anybody likes to make those disclosures we can do so now or at any time in the future at a future meeting. All right, are there any other questions? All right, no other business to come before the Committee, we are adjourned.