Thread by @ForARPeople1

Good morning Arkansas!

We are posted up in the Public Health, Welfare, and Labor Joint Subcommittee. Lots on the agenda, but one we're particularly interested in: Rep. Pilkington is presenting a number of proposals, some of which are targeted at reducing maternal mortality.

The biggest and most effective would be extending Medicaid coverage to new moms for 12 months after they give birth. This is a slam dunk, the data are pretty conclusive that it's a huge boon to mothers.

Naturally, then, Gov. Sanders has been... reluctant to support this.

To be clear, no laws will be passed today. Based on the agenda, Rep. Pilkington's proposals are being presented as Interim Study Proposals.

Usually this means the bill died in committee but the committee didn't want to kill it entirely.

They'll refer such bills to be studied in between legislative sessions to get more information on what the bill would do, what it will cost, how to achieve the goals of the bill, etc.

Sometimes ISPs eventually become law, and sometimes they don't. We'll see how this goes!

If it goes well today, we may see a push in the next legislative session to get Medicaid expansion for postpartum moms done, perhaps over the Gov's objections.

This is one of those days that might frame how the next general session will go, so we're interested in today's vibe.

Legislators are starting to file in, along with state employees.

If you want to read Pilkington's proposed bills for yourself, go and click "docs" next to today's meeting. His bills are exhibits C1-C5. Medicaid expansion is C2. arkleg.state.ar.us

They're taking their time getting started.

You'll also note Judiciary is meeting later this afternoon, where the ATF raid on Bryan Malinowski’s house earlier this year will be the only topic of discussion. Tune in at 1PM for our thread on that!
onarwatch.org/attorney-for-b…

Finally called to order. Sen. Irvin thanks legislators and staff for traveling to West Memphis for a series of meetings recently.

Rep. Pilkington is up, and he's starting with C4, which would establish a "blue envelope" program.

Blue Envelope programs are designed to help individuals that may have communication issues interact more safely with law enforcement. Essentially, there's an official envelope that all important documents are placed in; on the outside of the envelope are written instructions for law enforcement that might indicate communication issues - if someone has a stutter, is Deaf/Hard of Hearing, nonverbal, etc.

To clarify - this is for individuals with disabilities who can otherwise drive, so the documents are drivers licenses, registration, insurance, etc.

Rep. Pilkington has brought a few witnesses.

Director of Gov.'s Council on Disabilities here to present. Thinks it's a great program, it's becoming common across states.

Mr. Kaslowski, vice chair of the Gov's Council, is on the spectrum and is here to share a story about a traffic stop that might have gone more smoothly had he had a Blue Envelope.

He was working on a military post and hit a deer before he reached the exit.

The security guard was naturally confused about the damage to his car, and refused to let him leave until security had investigated. Mr. Kaslowski was overwhelmed and struggled to respond effectively to the security guard's questions. A Blue Envelope with his communication needs would have prevented the misunderstanding.

The second witness (missed the name, our apologies!) is a truck driver from Jacksonville and also on the spectrum.

He couldn't get over in time to get around a wreck without crossing dangerously into other lanes and was pulled over. Officer immediately escalated.

Again, a lot of misunderstanding and miscommunication that could have been avoided with a Blue Envelope. The witness ended up overwhelmed and escalating too, resulting in him getting tased.

Pilkington again: doesn't just benefit the drivers, but also helps to keep LEO safe. Pilkington hopes for a good vote so they can have a bill ready for Jan.

Irvin asks if there's cards inside the envelope describing the disability.

Pilkington says could be, but more often that info is printed on the outside of the envelope. The driver's documents are inside.

The envelopes also often come with instructions for the driver to remind them how traffic stops are supposed to go to help them from becoming overwhelmed.

Rep Johnson: could we extend this to parents with children with autism? Kids can easily get overwhelmed when their parents are pulled over.

A: would love to add something like that!

Sen. Love: curious re: standardization of what goes in the envelopes? What goes into the envelopes in other states that have this program? Do family members help place documents in the envelope?

A: insurance and licenses. Card that explains traffic stops. Description of disability and communication needs.

Love has concerns about a possible lack of standardization. Varying degrees of people on the spectrum, other disabilities that may involve communication issues.

Would like to see a more standardized way to communicating specific disability to LEO during a stop.

Rep. Wooldridge: Why does this require legislation? Could the Gov's Council just create the envelope and distribute it to those that want it?

A: would encourage statewide adoption and standardization. Would require officers across the state to understand the program.

ISP is adopted.

Pilkington going to speed through the other four, he says.

C1: require reimbursement for remote ultrasounds and remote fetal nonstress.

C2: Medicaid coverage 12 months postpartum.

C3: presumptive Medicaid eligibility for mothers.

C5: processed food safety. Mimicked after European Union rules.

No questions and without objection, all are adopted. Surprised there wasn't a bit of conversation re: Medicaid, as that bill died last session. Wonder if Pilkington's done enough behind the scenes work they'll get this passed.

DHS and Medical Services up to present a rule regarding hospital cost settlement reopening process. It lets more locations claim Medicare. Rule is reviewed.

Next one is Life360 targeted case management for pregnant women. Establishes a rate for services.

Northeast Arkansas hospitals are particularly excited about the rule.

Here's more about the Life360 program:

humanservices.arkansas.gov/divisions-shar…

Next up is a rule for private hospital access payment plans. They adjusted the rule to allow for more flexibility. Also reviewed!

Next up: rule making some changes to dental reimbursements. There's a bit of back and forth between Medicaid/Care and Children's Health Insurance Program (CHIP). CHIP seems to have more stringent requirements re: reimbursement and fee for service.

Delta Dental in public comment thought old way was just fine. DHS thinks there was a data anomaly in the year Delta Dental cites for their argument.

Sen. Boyd: we went with managed care in dentistry because dentists asked for it and payment was better. If payment had parity between managed care and fee for service, do we know what that would cost the state?

A: would have to pull those numbers. Consent decree currently sets rate.

(Consent decree means somebody sued the state years ago).

Rate reviews on dental haven't recommended rate increases because internal rates are comparable

Rep. Wooldridge: what is the fee in the fee for service payment structure?

A: reverting back right now - moving everyone in existing system for stability, but paying same rates.

6-12 months to complete the process.

Rep. Wardlaw, wearing a camo blazer: My dentists are happy with how things are going, but a type of filling that was covered under managed care and not under Medicare. It's a good filling for kids. Worried about accidentally committed fraud

A: meeting with Office of Medicaid Inspector General so we can put out clear guidance on this to ensure we can bridge the time until we can get proper codes in place.

Rep. Johnson: lots of discussion around data. Are we able to track what's going on with this big change?

A: more data is a reasonable request. We'll get you numbers we have so far.

Rule is reviewed.

Up next: rule regarding county workers eligible for disability benefits.

They're correcting a mistake that limited the kinds of waivers employees could apply for. Rule is reviewed!

Next up: Rules updating nursing home requirements.

Streamlines nursing home rules. Lengthy process for a lengthy rule to bring us closer to federal guidelines. Rule is reviewed!

Next up: Office of Preparedness and Emergency Response Systems - rule will comply with recent legislation changing the requirements for paramedics.

No questions - rule is reviewed!

Next up: rule relating to lead-based paint, also to comply with recent legislation.

No questions, rule is reviewed.

Next up: rule relating to advanced practiced registered nurse certifications. They added a classification change, tweaked rules surrounding administration of opioid antagonists, and delegation. All of this was to be more consistent with statute.

Tighter restrictions on stimulant administration; it's more stringent than statute but more in line with best practices.

Makes it easier for an out of state nurse to practice in Arkansas.

No questions, rule reviewed.

Final rule under consideration: delegation to nurses.

Gonzalez: wants to know if the rule constitutes a scope of practice change for Advanced Practice Nurses.

A: not really no. Fewer licensed individuals working, which increases workload on nurses. This frees them up some.

Irvin is worried that Medical Assistants are being delegated to give injections, but the rule gets reviewed.

Irvin encourages members to attend a subcommittee Ag meeting that will discuss the used tire issues. Sounds like that'll be a topic next session.

Pilkington notes that he's expecting a report on transferring postpartum moms pretty soon, so hopes that'll help clarify their work on expanding Medicaid.

No other business, we are adjourned! Thanks for following along.

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