UAMS' Pearl McElfish, ADH Chief of Staff Stephanie Williams

Over the voluble protests of state Sen. Missy Irvin (R-Mountain View) and a few of her colleagues in the Arkansas Legislative Council, the Northwest Arkansas Council won the body’s approval for $7 million in federal CARES Act funding to do COVID-19 testing, tracing and case investigations, especially among the Marshallese and Hispanic communities.

Pearl McElfish, the vice-chancellor for the University of Arkansas for Medical Sciences, made a convincing argument for a separate appropriation for the council: UAMS’ Office of Community Health and Research, which focuses on the Marshallese and Hispanic because of the health disparities in those communities. McElfish told the legislators that half of the office’s 60 employees are bilingual and the office has recruited Marshallese medical personnel — including one of the world’s two Marshallese physicians and Marshallese nurses. The office has worked for four years with the communities and has developed the relationships needed to test, trace and do enhanced case management, as recommended by Centers for Disease Control and Prevention experts who visited Northwest Arkansas after the coronavirus outbreak there. In Washington County, 21.3 percent of those tested have been found positive. The Marshallese, who make up a minuscule percentage of Arkansas’s population, account for 6 percent of COVID-19 cases and 7 percent of COVID-19 deaths statewide. In Northwest Arkansas, McElfish said, 70 percent of those who’ve tested positive are either Hispanic or Marshall Islanders, and she personally knows 20 people of Marshallese origin who have died in the past two weeks.

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Sen. Linda Chesterfield (D-Little Rock) moved for the proposal to be approved after only one question, from Rep. Fredrick Love (D-Little Rock), and her motion passed handily. The issue had been thoroughly debated by legislators with representatives from the Department of Health as they presented their request for $16 million in supplementary CARES Act funding for contact tracing, which was also approved after objections were made along the same lines by Irvin and others who thought that $22.4 million already approved for contact tracing should be enough and should cover Northwest Arkansas as well. The $22.4 million was for 350 contact tracers and hired General Dynamics Information Technology to boost the health department’s staff of 200 or so that has been working to contact all positive cases in Arkansas and the persons they’d come in contact with since becoming infected. With the surge in cases in June, Governor Hutchinson announced that he’d directed the health department to double the number of contact tracers. The supplemental appropriation will pay for 350 more contact tracers, many of whom have already been hired by the Arkansas Foundation for Medical Care. The CARES Act committee recommended the expenditure.

Jo Thompson,  the chief financial officer for the health department, told the legislators that more money may be needed in the fall to hire case investigators.

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Sen. Breanne Davis (R-Russellville) made a substitute motion to award NWC $4 million and direct the health department to spend $2.9 million on contact tracing in Northwest Arkansas out of its already supplemental funds. The motion failed.

Arguments against the NWC appropriation:

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Irvin said it made no sense to single out Northwest Arkansas with extra dollars that the health department should be spending and overseeing. “I don’t understand why the health department could not have done this with UAMS Northwest specifically. They had the ability, they had the appropriation … I’m not sure why it’s going through the Northwest Council,” Irvin said. “My objection is how this is flowing, not whether it is needed or not.” She added in final remarks that she expected to see regional contact tracing across the state as a result and asked the health department to send her its plan on that.

Sen. Alan Clark (R-Lonsdale) said he was “gravely disappointed” with the state’s handling of the Marshallese cases and complained that “I have not been asked up until Friday my opinion on any of it.” He questioned why the $16 million for ADH didn’t include $7 million for Northwest Arkansas and, in response to the already hired contractors information that hiring qualified Marshallese speakers was a “challenge,” asked if that meant that “somehow ADH is incapable of working with these people? Are we that incompetent? … We need to quit turning money loose. We need a plan.”

Rep. Robin Lundstrum (R-Springdale) said she thought the additional money requested by the council would be better spent on rental assistance, community care clinics, foodbanks and other social needs, especially since the Marshallese community was reluctant to communicate with contact tracers now.

In the earlier debate about the supplemental appropriation for ADH, several legislators drifted off into questions about hydroxychloroquine. Sen. Gary Stubblefield (R-Branch) asked if the department had tried to “suppress” the clinical use of the antimalarial drug touted by President Trump as beneficial for COVID-19 patients. Clark asked what action the health department had taken to affect the use of the drug, and a couple of legislators said they’d “heard” that the department had instructed pharmacies not to provide the drug. Answers: No, none, no. The department has issued guidance on the drug, ADH Chief of Staff Stephanie Williams said, noting that the FDA had removed its emergency use authorization because of adverse effects being seen in patients.

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