Shown verbatim: the complete text as captured from the official PDF posted by the Arkansas General Assembly, fetched 2026-07-23. Page and line markers are part of the official record; nothing is edited or removed. The official bill page.
Stricken language would be deleted from and underlined language would be added to present law.
1 State of Arkansas As Engrossed: H4/1/25
2 95th General Assembly
A Bill
3 Regular Session, 2025 HOUSE BILL 1270
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5 By: Representative Pilkington
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8 For An Act To Be Entitled
9 AN ACT TO ESTABLISH A PRESCRIBED PEDIATRIC EXTENDED
10 CARE PILOT PROGRAM THROUGH A SECTION 1115 MEDICAID
11 DEMONSTRATION WAIVER; TO REQUIRE THE DEPARTMENT OF
12 HUMAN SERVICES TO ADMINISTER THE PRESCRIBED PEDIATRIC
13 EXTENDED CARE PILOT PROGRAM IN THREE COUNTIES OF THIS
14 STATE; TO DECLARE AN EMERGENCY;
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17 Subtitle
18 TO ESTABLISH A PRESCRIBED PEDIATRIC
19 EXTENDED CARE PILOT PROGRAM THROUGH A
20 SECTION 1115 MEDICAID DEMONSTRATION
21 WAIVER; AND TO DECLARE AN EMERGENCY.
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23 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF ARKANSAS:
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25 SECTION 1. DO NOT CODIFY. TEMPORARY LANGUAGE. Prescribed Pediatric
26 Extended Care Pilot Program.
27 (a)(1) The Department of Human Services shall establish a Prescribed
28 Pediatric Extended Care Pilot Program to provide specialized, nonresidential
29 medical care for children with medically complex conditions.
30 (2) The pilot program shall:
31 (A) Operate in three (3) counties, strategically selected
32 within the most densely populated counties of the state, as determined by the
33 department;
34 (B) Function under a Section 1115 Medicaid Demonstration
35 Waiver, allowing the Arkansas Medicaid Program to cover prescribed pediatric
36 extended care services as an alternative to home health and private duty
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1 nursing; and
2 (C) Focus on the following objectives:
3 (i) Expand access to cost-effective, community-based
4 pediatric extended care for children with medically complex conditions;
5 (ii) Reduce avoidable hospitalizations and emergency
6 department visits for enrolled children;
7 (iii) Provide caregiver training and support
8 services to families, improving long-term health outcomes; and
9 (iv) Assess the feasibility of a permanent statewide
10 pediatric extended care program.
11 (b)(1) The department shall apply for a Section 1115 Medicaid
12 Demonstration Waiver to secure federal approval for the pilot program within
13 six (6) months of the effective date of this act.
14 (2) The waiver application shall outline:
15 (A) The eligibility criteria for participating children,
16 including children who require continuous skilled nursing care or therapeutic
17 interventions;
18 (B) The Medicaid reimbursement mechanisms for prescribed
19 pediatric extended care services;
20 (C) Methods to evaluate cost savings and health outcomes;
21 and
22 (D) Any necessary adjustments to existing Medicaid
23 benefits, including private duty nursing and home health services.
24 (c) Upon approval by the Centers for Medicare & Medicaid Services, the
25 department shall implement the pilot program no later than January 1, 2027.
26 (d) To qualify for services under the pilot program, a child shall:
27 (1) Be under twenty-one (21) years of age;
28 (2) Be medically dependent or technologically dependent, as
29 certified by a licensed physician;
30 (3) Require a level of care that would otherwise be provided in
31 a hospital or skilled nursing facility; and
32 (4) Have a caregiver who consents to participation and engages
33 in required training.
34 (e)(1) The department shall conduct an annual evaluation of the pilot
35 program, assessing:
36 (A) Health outcomes of enrolled children;
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1 (B) Cost-effectiveness compared to traditional Medicaid
2 services; and
3 (C) Caregiver satisfaction and burden reduction.
4 (2) A comprehensive final report shall be submitted to the
5 Governor and the General Assembly by December 31, 2030, with recommendations
6 on whether to expand, modify, or terminate the pilot program.
7 (f)(1) The pilot program shall operate for a period of five (5) years
8 unless extended by the General Assembly.
9 (2) If the department determines that the pilot program is not
10 meeting its intended goals, the department may submit a request to Centers
11 for Medicare & Medicaid Services to modify or terminate the waiver before the
12 scheduled expiration date.
13 (g) The department shall adopt rules necessary to implement the pilot
14 program, including:
15 (1) Licensing and operational standards for prescribed pediatric
16 extended care facilities;
17 (2) Medicaid reimbursement rates and provider enrollment
18 requirements; and
19 (3) Data collection protocols for evaluating the pilot program
20 effectiveness.
21 (h) The department may collaborate with pediatric hospitals, home
22 health providers, and community organizations to facilitate the pilot
23 program's success.
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25 SECTION 2. EMERGENCY CLAUSE. It is found and determined by the
26 General Assembly of the State of Arkansas that this state lacks sufficient
27 alternative care settings for children with medically complex conditions;
28 that due to lack of sufficient alternative care settings, children with
29 medically complex conditions often have unnecessary hospitalizations, which
30 results in increased expenditures to the state and in the Arkansas Medicaid
31 Program; that unnecessary hospitalizations in children can lead to
32 preventable harm, including infections; and that this act is immediately
33 necessary because increasing alternative care settings for children with
34 medically complex conditions protects the health of the children of this
35 state. Therefore, an emergency is declared to exist, and this act being
36 immediately necessary for the preservation of the public peace, health, and
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1 safety shall become effective on:
2 (1) The date of its approval by the Governor;
3 (2) If the bill is neither approved nor vetoed by the Governor,
4 the expiration of the period of time during which the Governor may veto the
5 bill; or
6 (3) If the bill is vetoed by the Governor and the veto is
7 overridden, the date the last house overrides the veto.
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9 /s/Pilkington
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4 04-01-2025 10:01:21 JMB269Every fact on this page links to its source, starting with the official bill record.