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Arkansas General Assembly· HB 1653Notification that HB1653 is now Act 636

An act TO MOVE LICENSING AND REGULATION OF 10 PSYCHIATRIC RESIDENTIAL TREATMENT FACILITIES FROM THE 11 CHILD WELFARE AGENCY REVIEW BOARD TO THE DEPARTMENT 12 OF HUMAN SERVICES, the official text

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: H3/5/25 H3/31/25
2 95th General Assembly
                                  A Bill

3 Regular Session, 2025                                           HOUSE BILL 1653

4

5 By: Representatives Cavenaugh, Wooldridge

6 By: Senator Irvin

7

8                        For An Act To Be Entitled

9   AN ACT TO MOVE LICENSING AND REGULATION OF

10  PSYCHIATRIC RESIDENTIAL TREATMENT FACILITIES FROM THE

11  CHILD WELFARE AGENCY REVIEW BOARD TO THE DEPARTMENT

12  OF HUMAN SERVICES; TO SET STANDARDS FOR THE LICENSING

13  AND REGULATION OF PSYCHIATRIC RESIDENTIAL TREATMENT

14  FACILITIES; TO DECLARE AN EMERGENCY; AND FOR OTHER

15  PURPOSES.

16

17

18                                           Subtitle

19                       TO SET STANDARDS FOR LICENSING AND

20                       REGULATION OF PSYCHIATRIC RESIDENTIAL

21                       TREATMENT FACILITIES; AND TO DECLARE AN

22                       EMERGENCY.

23

24 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF ARKANSAS:

25

26  SECTION 1. Arkansas Code � 20-8-107(c) and (d), concerning the

27 expansion of facilities or services permitted by Health Services Permit

28 Agency, are amended to read as follows:

29  (c) In no event shall the requirements of this subchapter apply to any

30 facility licensed or approved as of March 1, 2003, by the Child Welfare

31 Agency Review Board pursuant to the Child Welfare Agency Licensing Act, � 9-

32 28-401 et seq., and as specifically exempted by � 9-28-407(a)(3).

33  (d) Beginning July 1, 2005, the Health Services Permit Agency may not

34 accept applications or requests for permits of approval to add new beds or to

35 expand existing bed capacity of residential care facilities.

36  (d)(1) The Health Services Permit Agency shall recognize an exception

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1 to the moratorium regarding bed capacity and beds in a psychiatric

2 residential treatment facility.

3   (2) The Health Services Permit Agency shall add to the permitted

4 bed capacity for psychiatric residential treatment facilities:

5                    (A) Beds that are not currently permitted by the Health

6 Services Permit Agency but are licensed by the Child Welfare Agency Review

7 Board for the purpose of operating as a psychiatric residential treatment

8 facility before the effective date of this subsection; and

9                    (B) Beds that are fully constructed and could be used for

10 the purpose of operating a psychiatric residential treatment facility as of

11 January 1, 2025.

12  (3) The total amount of additional beds authorized under this

13 subsection shall not exceed nine hundred (900) beds for the purpose of

14 operating as a psychiatric residential treatment facility.

15  (4) The Health Services Permit Agency shall require prior

16 approval under � 20-8-109 for any new construction of a psychiatric

17 residential treatment facility and for any renovation project that exceeds

18 two hundred fifty thousand dollars ($250,000) for an existing psychiatric

19 residential treatment facility.

20  (5) Any increase or decrease in the total number of authorized

21 beds under this section shall be reviewed and approved by the Legislative

22 Council before receiving a permit from the Health Services Permit Agency or a

23 license from the Office of Long-Term Care.

24  (6) For the purposes of this section, beds used for both in-

25 state and out-of-state clients shall be counted in capacity for the purpose

26 of obtaining a permit from the Health Services Permit Agency.

27

28  SECTION 2. Arkansas Code � 20-10-101(1), concerning the definition of

29 "administrative remedy" relating to long-term care facilities and services,

30 is amended to read as follows:

31  (1) "Administrative remedy" means temporary management, denial

32 of payment for all new admissions, transfer of residents, termination or

33 suspension of license, termination of provider agreement, directed plan of

34 correction, directed in-service training, and remedies established by

35 Arkansas law, including remedies provided in � 20-10-1408 [repealed];

36

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1          SECTION 3. Arkansas Code � 20-10-101(9)(A), concerning the definition

2 of "long-term care facility" relating to long-term care facilities and

3 services, is amended to read as follows:

4          (9)(A) "Long-term care facility" means a nursing home,

5 residential care facility, assisted living facility, psychiatric residential

6 treatment facility, post-acute head injury retraining and residential care

7 facility, or any other facility which provides long-term medical or personal

8 care.

9

10         SECTION 4. Arkansas Code � 20-10-101, concerning definitions relating

11 to long-term care facilities and services, is amended to add an additional

12 subdivision to read as follows:

13         (16)(A) "Psychiatric residential treatment facility" means a

14 standalone, nonhospital facility with a provider agreement with the Arkansas

15 Medicaid Program to provide inpatient services benefits to individuals who

16 are under twenty-one (21) years of age and that:

17               (i) Is accredited by The Joint Commission or any

18 other accrediting organization with comparable standards recognized by this

19 state;

20               (ii) Attests to meeting the conditions of

21 participation found at 42 C.F.R. Part 483, Subpart G, as existing on January

22 1, 2025; and

23               (iii) Attests that all of the residents in the

24 facility meet the certification of need for services requirements as

25 identified under 42 C.F.R. Part 441, Subpart D, as existing on January 1,

26 2025.

27               (B)(i) A survey and certification review of a psychiatric

28 residential treatment facility by the department shall apply to all residents

29 being served by the entity regardless of residency or payment source.

30               (ii) All residents of a psychiatric residential

31 treatment facility shall require intensive inpatient services for psychiatric

32 conditions under the direction of a physician and the services provided shall

33 be reasonably expected to improve the resident's condition or prevent further

34 regression until the services are no longer needed.

35

36         SECTION 5. Arkansas Code � 20-10-110(a)(2), concerning the definition

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1 of "long-term care facility" relating to the protection of residents'

2 personal funds, is amended to read as follows:

3               (2) "Long-term care facility" means a nursing home, residential

4 care facility, post-acute head injury retraining and residential care

5 facility, assisted living facility, psychiatric residential treatment

6 facility, or any other facility that provides long-term medical or personal

7 care;

8

9 SECTION 6. Arkansas Code � 20-10-402 is amended to read as follows:

10       20-10-402. License required.

11       (a) It shall be unlawful for any person to act or serve in the

12 capacity of nursing home long-term care facility administrator in this state

13 unless the person has been licensed to do so as authorized in this

14 subchapter.

15       (b) A person who serves as an administrator of a long-term care

16 facility conducted exclusively for persons who rely upon treatment by

17 spiritual means through prayer in accordance with the creed or tenets of a

18 church or religious denomination shall be exempt from subsection (a) of this

19 section and � 20-10-101(1)-(6), � 20-10-203(b), � 20-10-212, �� 20-10-301 --

20 20-10-303 [repealed], � 20-10-403, � 20-10-405(b) � 20-10-405(a)(2), � 20-10-

21 406, and � 20-10-407.

22

23       SECTION 7. Arkansas Code � 20-10-404(a), concerning the application

24 and fees for licensure as a long-term care facility administrator, is amended

25 to read as follows:

26       (a) Any person desiring to be licensed as a nursing home long-term

27 care facility administrator shall make application to the Office of Long-Term

28 Care on forms prescribed by the office and shall furnish such information

29 with the application as shall be required by the office.

30

31       SECTION 8. Arkansas Code � 20-10-405 is amended to read as follows:

32       20-10-405. Renewal.

33       (a)(1) Every active nursing home administrator's license shall be

34 renewed on or before July 1 of each year by paying a fee of one hundred

35 dollars ($100) to the Office of Long-Term Care and by furnishing written

36 documentation that the licensee has attended and accumulated a specific

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1 number of continuing education clock hours as established by the office.

2   (b)(2) The fee for those nursing home administrators not actively

3 employed by a nursing home facility as an administrator shall be fifty

4 dollars ($50.00), payable on or before July 1 of each year.

5   (c)(3) If the annual licensure fee in full along with the renewal

6 application and satisfactory documentation of compliance with continuing

7 education requirements is not postmarked or received by the office on or

8 before July 1, the licensee shall be ineligible to perform the duties of

9 nursing home administrator, and the license shall be deemed suspended

10 effective July 2.

11  (d)(4) No request for renewal postmarked or received by the office

12 after July 1 shall be considered unless, in addition to other requirements

13 imposed by law or rule, the licensee tenders a late charge in the amount of

14 fifty dollars ($50.00).

15  (e)(5) Any nursing home administrator license not renewed on or before

16 September 1 shall expire effective September 2.

17  (b) An administrator for a long-term care facility other than a

18 nursing home shall be required to renew his or her license as follows:

19  (1) Every active administrator license shall be renewed on or

20 before January 1 of each year by submitting a renewal application to the

21 Department of Human Services and by furnishing written documentation that the

22 licensee has attended and accumulated a specific number of continuing

23 education clock hours as established by the department;

24  (2) If the renewal application and satisfactory documentation of

25 compliance with continuing education requirements is not postmarked or

26 received by the department on or before January 1, the licensee shall be

27 ineligible to perform the duties of long-term care facility administrator,

28 and the license shall be deemed suspended effective January 2;

29  (3) A request for renewal postmarked or received by the

30 department after January 1 shall not be considered unless the licensee

31 complies with all of the requirements imposed by law or rule; and

32  (4) Any long-term care facility administrator license not

33 renewed on or before March 1 shall expire effective March 2.

34

35  SECTION 9. Arkansas Code � 20-10-407(a), concerning the denial,

36 revocation, or suspension of a long-term care facility administrator's

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1 license, is amended to read as follows:

2   (a) The Department of Human Services may refuse to issue or renew a

3 long-term care facility administrator's license or may revoke or suspend the

4 license of a long-term care facility administrator if the department finds

5 that the applicant or licensee does not qualify for licensure or has violated

6 � 20-10-101(1)-(6), � 20-10-203(b), � 20-10-212, �� 20-10-402 and 20-10-403,

7 � 20-10-405(b) � 20-10-405(a)(2), � 20-10-406, and this section or rules of

8 the department relating to the proper administration and management of a

9 long-term care facility.

10

11  SECTION 10. Arkansas Code Title 20, Chapter 46, Subchapter 4 is

12 amended to read as follows:

13  Subchapter 4 -- Psychiatric Residential Treatment Facilities

14

15  20-46-401 - 20-46-404. [Repealed.]

16

17  20-46-401. Admission of children to psychiatric residential treatment

18 facilities.

19  (a) A psychiatric residential treatment facility licensed under this

20 subchapter and holding a permit from the Health Services Permit Agency or the

21 Health Services Permit Commission shall not admit a child for psychiatric

22 residential treatment unless the child is:

23              (1) An Arkansas resident;

24              (2) A child of a parent who is an Arkansas resident;

25              (3) A child placed by or on behalf of another state's child

26 welfare agency;

27              (4) A child for whom the facility is being paid by another

28 state's Medicaid program;

29              (5) A child of an active-duty member or veteran of the uniformed

30 services as defined in � 6-4-302; or

31              (6) A nonresident child victim of human trafficking when the

32 regulated facility maintains responsibility for the return of the child to an

33 out-of-state custodian.

34  (b) The Department of Human Services may promulgate rules to enforce

35 this section.

36

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1

2   20-46-402. Licensure -- Unlawful acts.

3   (a)(1) It is unlawful for any person, partnership, group, corporation,

4 association, or other entity or identifiable group of entities having a

5 coordinated ownership with controlling interest to operate or assist in the

6 operation of a psychiatric residential treatment facility that has not been

7 licensed by the Office of Long-Term Care under this subchapter.

8   (2) Before obtaining a license under this subchapter, a

9 psychiatric residential treatment facility shall obtain a permit from the

10 Health Services Permit Agency or Health Services Permit Commission to operate

11 in Arkansas.

12  (3) The bed capacity allowed by the permit issued by the Health

13 Services Permit Agency or Health Services Permit Commission includes both in-

14 state and out-of-state clients.

15  (4) Any expansion of bed capacity by an existing licensee shall

16 require a license from the office and a permit from the Health Services

17 Permit Agency.

18  (5)(A) A license issued by the office under this subchapter is

19 effective unless revoked, suspended, or terminated by the office.

20                    (B) In addition to any other basis provided by law or

21 rule, the Department of Human Services shall terminate the license of a

22 psychiatric residential treatment facility licensee that has not been in

23 operation for a consecutive twelve-month period.

24                    (C) The department may revoke, suspend, or terminate a

25 license upon any basis provided by law or rule, including without limitation

26 the failure to be in operation or in substantial compliance for a consecutive

27 six-month period.

28  (b) It is unlawful for any person to falsify an application for

29 licensure, to knowingly circumvent the authority of this subchapter, to

30 knowingly violate the orders issued by the department, or to advertise for

31 inpatient psychiatric residential treatment when not licensed under this

32 subchapter to provide those services.

33  (c) Any violation of this section shall constitute a Class D felony.

34

35  20-46-403. Licensure posting and display.

36  If the Department of Human Services issues a license to operate a

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1 psychiatric residential treatment facility, the license shall be posted and

2 displayed in a conspicuous place in the facility and must state at a minimum:

3               (1) The full legal name of the person, partnership, group,

4 corporation, organization, association, or other entity or identifiable group

5 of entities having a coordinated ownership with controlling interest holding

6 the license, including the business name, if different;

7               (2) The address of the psychiatric residential treatment

8 facility;

9               (3) The effective date and expiration date of the license, if

10 applicable;

11              (4) The type of psychiatric residential treatment facility the

12 licensee is authorized to operate;

13              (5) The ages and maximum number of children that may receive

14 services from the psychiatric residential treatment facility;

15              (6) The status of the license, whether regular, provisional, or

16 probationary; and

17              (7) Any special conditions or limitations of the license.

18

19  20-46-404. Services provided by psychiatric residential treatment

20 facilities.

21  (a) A psychiatric residential treatment facility licensed under this

22 subchapter shall:

23              (1)(A) Provide a range of comprehensive services to treat the

24 psychiatric condition of residents on an inpatient basis under the direction

25 of a physician.

26                    (B) The psychiatric residential treatment facility shall

27 certify that:

28                    (i) Ambulatory care services available in the

29 community do not meet the treatment needs of the resident;

30                    (ii) Proper treatment of the resident's psychiatric

31 condition requires services on an inpatient basis under the direction of a

32 physician; and

33                    (iii) The services can reasonably be expected to

34 improve the resident's condition or prevent further regression so that the

35 services will no longer be needed.

36                    (C) The certification required in subdivision (a)(1)(B) of

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1 this section shall be made by an independent team that:

2                     (i) Includes a physician;

3                     (ii) Has competence in diagnosis and treatment of

4 mental illness, preferably in child psychiatry; and

5                     (iii) Has knowledge of the resident's situation; and

6   (2) Provide services to a resident according to an individual

7 plan of care that:

8   (A) Is based on a diagnostic evaluation that includes

9 examination of the medical, psychological, social, behavioral, and

10 developmental aspects of the resident's situation and reflects the need for

11 inpatient psychiatric care;

12  (B) Is developed by a team of professionals in

13 consultation with the resident, parents, legal guardians, or other

14 individuals in whose care the resident will be released after discharge;

15  (C) Describes clear and concise treatment objectives;

16  (D) Ensures continuity of care with the resident's family,

17 school and educational requirements, and community upon discharge;

18  (E) Determines that services being provided are or were

19 required on an inpatient basis; and

20  (F) Recommends changes in the plan of care as indicated by

21 the resident's overall adjustment as an inpatient.

22  (b) The Department of Human Services shall promulgate rules to

23 implement this subchapter, which shall include components that ensure quality

24 of care, health and safety of residents and facility staff, and compliance

25 with all educational requirements.

26

27

28  SECTION 11. Arkansas Code � 9-28-402(8), concerning the definition of

29 "child welfare agency" within the Child Welfare Agency Licensing Act, is

30 amended to read as follows:

31  (8) "Child welfare agency" means any person, corporation,

32 partnership, voluntary association, or other entity or identifiable group of

33 entities having a coordinated ownership of controlling interest, whether

34 established for profit or otherwise, that is not excluded under this

35 subchapter and engages in any of the following activities:

36  (A) Receives a total number of six (6) or more unrelated

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1 minors for care on a twenty-four-hour basis for the purpose of ensuring the

2 minors receive care, training, education, custody, or supervision, whether or

3 not there are six (6) or more children cared for at any single physical

4 location;

5                     (B) Places any unrelated minor for care on a twenty-four-

6 hour basis with persons other than themselves;

7                     (C) Plans for or assists in the placements described in

8 subdivision (8)(B) of this section; or

9                     (D) Receives, places, plans, or assists in the placement

10 of a child victim of human trafficking in a home or any type of shelter or

11 facility;

12

13  SECTION 12. Arkansas Code � 9-28-402(12), concerning the definition of

14 "exempt child welfare agency" within the Child Welfare Agency Licensing Act,

15 is amended to read as follows:

16            (12) "Exempt child welfare agency" means any person,

17 corporation, partnership, voluntary association or other entity, whether

18 established for profit or otherwise, that otherwise fits the definition of a

19 child welfare agency but that is specifically exempt from the requirement of

20 obtaining a license under this subchapter. Those agencies specifically exempt

21 from the license requirement are:

22                    (A) A facility or program owned or operated by an agency

23 of the United States Government;

24                    (B)(i) Any agency of the State of Arkansas that is

25 statutorily authorized to administer or supervise child welfare activities.

26                    (ii) In order to maintain exempt status, the state

27 child welfare agency shall state every two (2) years in written form signed

28 by the persons in charge that their agency is in substantial compliance with

29 published state agency child welfare standards.

30                    (iii) Visits to review and advise exempt state

31 agencies shall be made as deemed necessary by the Child Welfare Agency Review

32 Board to verify and maintain substantial compliance with the standards;

33                    (C) A facility or program owned or operated by or under

34 contract with the Division of Correction;

35                    (D) A hospital providing acute care licensed pursuant to �

36 20-9-201 et seq.;

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1       (E)(D) Any facility governed by the Department of Human

2 Services State Institutional System Board or its successor;

3       (F) Human development centers regulated by the Board of

4 Developmental Disabilities Services pursuant to the Location Act for

5 Community Homes for Individuals with Intellectual and Developmental

6 Disabilities, � 20-48-601 et seq.;

7       (G) Any facility licensed as a family home pursuant to the

8 Location Act for Community Homes for Individuals with Intellectual and

9 Developmental Disabilities, � 20-48-601 et seq.;

10      (H)(E) Any boarding school as defined in this section;

11      (I)(F) Any temporary camp as defined in this section;

12      (J)(G) Any state-operated facility to house juvenile

13 delinquents or any serious offender program facility operated by a state

14 designee to house juvenile delinquents. Those facilities shall be subject to

15 program requirements modeled on nationally recognized correctional facility

16 standards that shall be developed, administered, and monitored by the

17 Division of Youth Services; and

18      (K)(H) Any child welfare agency operated solely by a

19 religious organization that elects to be exempt from licensing and that

20 complies within the conditions of the exemption for church-operated agencies

21 as set forth in this subchapter;

22      (L) The Division of Developmental Disabilities Services;

23 and

24      (M) Any intellectual or other developmental disabilities

25 services waiver provider licensed under � 20-48-208 or the Location Act for

26 Community Homes for Individuals with Intellectual and Developmental

27 Disabilities, � 20-48-601 et seq.;

28

29      SECTION 13. Arkansas Code � 9-28-402(18) is repealed.

30      (18) "Psychiatric residential treatment facility" means a

31 residential childcare facility in a nonhospital setting that provides a

32 structured, systematic, therapeutic program of treatment under the

33 supervision of a psychiatrist, for children who are emotionally disturbed and

34 in need of daily nursing services, psychiatrist's supervision, and

35 residential care but who are not in an acute phase of illness requiring the

36 services of an inpatient psychiatric hospital;

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1

2   SECTION 14. Arkansas Code � 9-28-402(22), concerning the definition of

3 "residential childcare facility" within the Child Welfare Agency Licensing

4 Act, is amended to read as follows:

5            (22)(A) "Residential childcare facility" means any child welfare

6 agency that is not an excluded child welfare agency under this subchapter and

7 provides care, training, education, custody, or supervision on a twenty-four-

8 hour basis for six (6) or more unrelated children, excluding foster homes

9 that have six (6) or more children who are all related to each other but who

10 are not related to the foster parents.

11           (B) A "residential childcare facility" does not include a

12 facility that provides inpatient psychiatric treatment, which shall not be

13 licensed as a residential childcare facility;

14

15  SECTION 15. Arkansas Code � 9-28-402, concerning the definitions

16 within the Child Welfare Agency Licensing Act, is amended to add an

17 additional subdivision to read as follows:

18           (32) "Excluded child welfare agency" means any person,

19 corporation, partnership, voluntary association, or other entity, whether

20 established for-profit or otherwise, that meets the definition of a child

21 welfare agency or an exempt child welfare agency but is licensed or certified

22 by the Department of Human Services or the Department of Health and is

23 enrolled in the Arkansas Medicaid Program.

24

25  SECTION 16. Arkansas Code � 9-28-403(a), concerning the creation and

26 authority of the Child Welfare Agency Review Board, is amended to read as

27 follows:

28  (a)(1) There is created the Child Welfare Agency Review Board to serve

29 as the administrative body to carry out the provisions of this subchapter.

30           (2) The board shall have the authority to promulgate rules to

31 enforce the provisions of this subchapter.

32           (3) An excluded child welfare agency is not subject to the

33 provisions of this subchapter.

34

35  SECTION 17. Arkansas Code � 9-28-404(a)(5), concerning the membership

36 of the Child Welfare Agency Review Board, is repealed.

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1            (5) One (1) representative from a licensed psychiatric

2 residential treatment facility;

3

4   SECTION 18. Arkansas Code � 9-28-407(a)(3) and (4), concerning

5 licenses required and issued by the Child Welfare Agency Review Board, are

6 repealed.

7            (3) Any child welfare agency capacity licensed by the board as

8 of March 1, 2003, whether held by the original licensee or by a successor in

9 interest to the original licensee, is exempted from:

10                   (A) Obtaining any license or permit from the Office of

11 Long-Term Care; and

12                   (B)(i) Obtaining any permit from the Health Services

13 Permit Agency or the Health Services Permit Commission to operate at the

14 capacity licensed by the board as of March 1, 2003, except as required under

15 subdivision (a)(3)(B)(ii) of this section.

16                      (ii)(a) If a licensee is operating at less than or

17 at the capacity licensed by the board as of March 1, 2021, the licensee shall

18 obtain a permit from the Health Services Permit Agency or the Health Services

19 Permit Commission for any increase in capacity.

20                              (b) For the purposes of subdivision

21 (a)(3)(B)(ii)(a) of this section, both in-state and out-of-state clients

22 shall be counted in capacity for the purpose of obtaining a license from the

23 board and a permit from the Health Services Permit Agency or the Health

24 Services Permit Commission.

25                   (4) Any new license or expansion of capacity by an

26 existing licensee of the board shall require a license and permit from the

27 Office of Long-Term Care or the Health Services Permit Agency.

28

29  SECTION 19. Arkansas Code � 9-28-407(a)(5), concerning licenses

30 required and issued by the Child Welfare Agency Review Board, is amended to

31 read as follows:

32           (5)(A) A license issued by the board under this subchapter is

33 effective unless revoked, suspended, or terminated by the board.

34                   (B) In addition to any other basis provided by law or

35 rule, the board shall terminate the license of a psychiatric residential

36 treatment facility licensee that has not been in operation for a consecutive

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1 twelve-month period.

2                   (C) The Department of Human Services may recommend to the

3 board the revocation, suspension, or termination of a license for any basis

4 provided by law or rule, including without limitation the failure to be in

5 operation or in substantial compliance for a consecutive six-month period.

6

7   SECTION 20. Arkansas Code � 9-28-407(f)(3)(F), concerning licenses

8 required and issued by the Child Welfare Agency Review Board, is amended to

9 read as follows:

10                  (F) The provisions of subsection (a) of this section,

11 including those provisions regarding obtaining licenses or permits from the

12 Office of Long-Term Care and regarding obtaining any permits from the Health

13 Services Permit Agency or the Health Services Permit Commission, shall apply

14 in their entirety to the new owner of the child welfare agency

15

16  SECTION 21. Arkansas Code � 9-28-416 is repealed.

17  9-28-416. Admission of children to psychiatric residential treatment

18 facilities.

19  (a) A psychiatric residential treatment facility licensed under this

20 subchapter and holding a permit from the Health Services Permit Agency or the

21 Health Services Permit Commission shall not admit a child for psychiatric

22 residential treatment unless the child is:

23              (1) An Arkansas resident;

24              (2) A child of a parent who is an Arkansas resident;

25              (3) A child placed by or on behalf of another state's child

26 welfare agency;

27              (4) A child for whom the facility is being paid by another

28 state's Medicaid program;

29              (5) A child of an active-duty member or veteran of the uniformed

30 services as defined in � 6-4-302; or

31              (6) A nonresident child victim of human trafficking when the

32 regulated facility maintains responsibility for the return of the child to

33 the out-of-state custodian.

34  (b) The Department of Human Services may promulgate rules to enforce

35 this section.

36

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    As Engrossed: H3/5/25 H3/31/25                                        HB1653

1   SECTION 22. Arkansas Code Title 9, Chapter 28, Subchapter 13, is

2 repealed.

3   Subchapter 13 -- Psychiatric Residential Treatment Facilities and Other

4                                Regulated Facilities

5

6   9-28-1301. Definitions.

7   As used in this subchapter:

8            (1) "Psychiatric residential treatment facility" means the same

9 as defined in � 9-28-402; and

10           (2) "Regulated facility" means:

11                   (A) A psychiatric residential treatment facility licensed

12 under the Child Welfare Agency Licensing Act, � 9-28-401 et seq.; and

13                   (B) A psychiatric hospital licensed under � 20-9-201 et

14 seq., that admits a child for the purpose of providing behavioral health

15 treatment, regardless of whether the child is placed in an acute, subacute,

16 or otherwise unlicensed bed.

17

18  9-28-1302. Quality of care -- Quality assurance reviews.

19  (a) The Department of Human Services shall promulgate rules setting

20 minimum standards and metrics governing the quality of care provided by a

21 regulated facility to a child.

22  (b) Quality of care standards shall include that a regulated facility

23 shall provide:

24           (1) Trauma-informed programming and clinical services and, when

25 applicable, evidence-based treatments;

26           (2) Services that will be short-term, target treatment episodes

27 to reduce the likelihood of re-entry into residential treatment settings;

28           (3) Services that are family-driven and youth-guided;

29           (4) Mental health services and clinical services provided by

30 clinical staff as appropriate for the child's needs;

31           (5) Educational services in compliance with state and federal

32 law and rules of the Department of Education;

33           (6) Coordination of all needs including medical, dental, and

34 other needs; and

35           (7) Clinical discharge planning throughout the child's stay that

36 includes the custodian and child involvement.

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    As Engrossed: H3/5/25 H3/31/25                                          HB1653

1   (c)(1) The Department of Human Services and its designees may inspect

2 and investigate the quality of care for behavioral health provided to any

3 child admitted to a regulated facility, whether or not the child is an

4 Arkansas resident.

5               (2) The Department of Human Services or any other public agency

6 having authority or responsibility with respect to child maltreatment,

7 including without limitation the Medicaid Fraud Control Unit of the Attorney

8 General's office, may investigate any alleged or suspected child maltreatment

9 in any regulated facility.

10  (d) The Department of Human Services shall conduct quality assurance

11 reviews for each regulated facility, consisting of the following:

12              (1) A review of treatment structure including without

13 limitation:

14                 (A) Observation of paraprofessional and direct-care staff

15 interaction with patients;

16                 (B) Review of daily activity structure outside of school

17 and treatment;

18                 (C) Review of paraprofessional and direct-care staff

19 training and personnel records;

20                 (D) Review of staff-to-client ratios; and

21                 (E) Completion of client interviews;

22              (2) An analysis of referral data, statistics, and psychotropic

23 medication prescriptions;

24              (3) An on-site visit of a regulated facility's operation, to be

25 conducted at least once per year; and

26              (4) Technical assistance and ongoing quality assurance and

27 collaboration as needed.

28  (e) This subchapter does not require any additional licensure or

29 certification for a regulated facility.

30

31  9-28-1303. Department enforcement authority.

32  (a) The Department of Human Services may initiate an adverse action

33 against a regulated facility that:

34              (1) Fails to comply with the provisions of this subchapter or

35 any rule of the department relating to quality of care;

36              (2) Furnishes or makes any statement or report to the department

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    As Engrossed: H3/5/25 H3/31/25                                          HB1653

1 that is false or misleading;

2              (3) Refuses or fails to submit required reports or to make

3 available to the department any records required by the department in making

4 an investigation of the agency for quality of care purposes;

5              (4) Refuses or fails to submit to an investigation or to

6 reasonable inspection by the department;

7              (5) Retaliates against an employee who in good faith reports a

8 suspected violation of the provisions of this subchapter or the rules

9 promulgated under this subchapter;

10             (6) Fails to engage in a course of professional conduct in

11 dealing with clients being served by the regulated facility, as defined by

12 rules promulgated under this subchapter; or

13             (7) Demonstrates gross negligence in carrying out the duties at

14 the regulated facility.

15  (b) The department may impose an adverse action as follows:

16             (1) Issue letters of reprimand or caution;

17             (2) Require a corrective action plan; and

18             (3)(A) Impose civil penalties of up to two thousand five hundred

19 dollars ($2,500) per violation, with each day of noncompliance and each

20 client injured as a result of noncompliance constituting a separate

21 violation.

22             (B) If any person upon whom the department has levied a

23 civil penalty fails to pay the civil penalty within sixty (60) days of the

24 decision of the department to impose the penalty, the amount of the fine

25 shall be considered to be a debt owed to the State of Arkansas and may be

26 collected by civil action.

27             (C) Civil penalties collected under this section may be

28 expended only for the purpose of providing technical assistance and training

29 to regulated facilities.

30  (c)(1) For a regulated facility licensed under the Child Welfare

31 Agency Licensing Act, � 9-28-401 et seq., the department may petition the

32 Child Welfare Agency Review Board to deny, suspend, or revoke the regulated

33 facility's license on the basis of any adverse action imposed by the

34 department under this section.

35             (2) For a regulated facility licensed under � 20-9-201 et seq.,

36 the department may petition the State Board of Health to deny, suspend, or

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    As Engrossed: H3/5/25 H3/31/25                                          HB1653

1 revoke the regulated facility's license on the basis of any adverse action

2 imposed by the department under this section.

3   (d) The department shall notify the regulated facility of the adverse

4 action of the department in writing and set forth the facts forming the basis

5 for the adverse action.

6   (e)(1) Adverse action hearings shall comply with the Arkansas

7 Administrative Procedure Act, � 25-15-201 et seq.

8               (2) Within ten (10) business days after rendering a decision,

9 the department shall forward to the regulated facility written findings of

10 fact and conclusions of law articulating the decision of the department.

11

12  9-28-1304. Rules.

13  The Department of Human Services shall promulgate rules to implement

14 this subchapter.

15

16  SECTION 23. DO NOT CODIFY. TEMPORARY LANGUAGE. Rules.

17  (a) Beds within a psychiatric residential treatment facility, whether

18 licensed on the effective date of this act or otherwise, shall not be

19 approved and licensed under the new regulatory structure established in this

20 act until:

21              (1) The Office of Long-Term Care promulgates a certification

22 manual; and

23              (2) The Arkansas Medicaid Program promulgates a provider manual

24 for psychiatric residential treatment facility services.

25  (b) Providers of psychiatric residential treatment facility services

26 in this state shall have one (1) year from the effective date of this act to

27 develop, implement, and operate services that establish the appropriate

28 continuum of care for families as defined by the Department of Human

29 Services.

30

31  SECTION 24. EMERGENCY CLAUSE. It is found and determined by the

32 General Assembly of the State of Arkansas that beds in psychiatric

33 residential treatment facilities have been permitted but are not currently

34 licensed; that these beds in psychiatric residential treatment facilities

35 that are not licensed cannot be used for children in need of healthcare

36 services despite the demand for the beds; that this act would authorize

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    As Engrossed: H3/5/25 H3/31/25                                      HB1653

1 licensing of the beds in psychiatric residential treatment facilities and

2 therefore allow the use of these beds in psychiatric residential treatment

3 facilities for children in need; and that this act is immediately necessary

4 to provide healthcare services to children in need across this state who are

5 currently not able to be admitted into a psychiatric residential treatment

6 facility. Therefore, an emergency is declared to exist, and this act being

7 immediately necessary for the preservation of the public peace, health, and

8 safety shall become effective on:

9            (1) The date of its approval by the Governor;

10           (2) If the bill is neither approved nor vetoed by the Governor,

11 the expiration of the period of time during which the Governor may veto the

12 bill; or

13           (3) If the bill is vetoed by the Governor and the veto is

14 overridden, the date the last house overrides the veto.

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Every fact on this page links to its source, starting with the official bill record.