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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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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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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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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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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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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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19 03-31-2025 13:35:19 JMB064Every fact on this page links to its source, starting with the official bill record.