Bill Summary – FastDemocracy

Stricken language would be deleted from and underlined language would be added to present law.
                                           Act 806 of the Regular Session
 State of Arkansas        As Engrossed:       H3/13/23 H3/15/23 S4/5/23
 94th General Assembly                        A Bill
 Regular Session, 2023                                                             HOUSE BILL 1446
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 By: Representatives Cavenaugh, Vaught
 By: Senator K. Hammer
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                                   For An Act To Be Entitled
                AN ACT TO PROVIDE STATE OVERSIGHT OF QUALITY OF CARE
                PROVIDED TO CHILDREN IN PSYCHIATRIC RESIDENTIAL
                TREATMENT FACILITIES AND OTHER REGULATED FACILITIES;
                AND FOR OTHER PURPOSES.
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                                               Subtitle
                         TO PROVIDE STATE OVERSIGHT OF QUALITY OF
                         CARE PROVIDED TO CHILDREN IN PSYCHIATRIC
                         RESIDENTIAL TREATMENT FACILITIES AND
                         OTHER REGULATED FACILITIES.
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 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF ARKANSAS:
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        SECTION 1. Arkansas Code Title 9, Chapter 28, Subchapter 4, is amended
 to add a new section to read as follows:
        9-28-416. Admission of children to psychiatric residential treatment
 facilities.
        (a)    A psychiatric residential treatment facility licensed under this
 subchapter and holding a permit from the Health Services Permit Agency or the
 Health Services Permit Commission shall not admit a child for psychiatric
 residential treatment unless the child is:
                (1)      An Arkansas resident;
                (2)      A child of a parent who is an Arkansas resident;
                (3)      A child placed by or on behalf of another state’s child
 welfare agency;
                (4)      A child for whom the facility is being paid by another
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     As Engrossed:    H3/13/23 H3/15/23 S4/5/23                                 HB1446
 state's Medicaid program;
            (5)    A child of an active-duty member or veteran of the uniformed
 services as defined in § 6-4-302; or
            (6)    A nonresident child victim of human trafficking when the
 regulated facility maintains responsibility for the return of the child to
 the out-of-state custodian.
      (b)   The Department of Human Services may promulgate rules to enforce
 this section.
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      SECTION 2. Arkansas Code Title 9, Chapter 28, is amended to add an
 additional subchapter to read as follows:
    Subchapter 13 — Psychiatric Residential Treatment Facilities and Other
                               Regulated Facilities
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      9-28-1301.    Definitions.
      As used in this subchapter:
            (1)    “Psychiatric residential treatment facility” means the same
 as defined in § 9-28-402; and
            (2)    “Regulated facility” means:
                    (A)   A psychiatric residential treatment facility licensed
 under § 9-28-401 et seq.; and
                    (B)   A psychiatric hospital licensed under the Child
 Welfare Agency Licensing Act, § 20-9-201 et seq., that admits a child for the
 purpose of providing behavioral health treatment, regardless of whether the
 child is placed in an acute, subacute, or otherwise unlicensed bed.
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      9-28-1302.    Quality of care — Quality assurance reviews.
      (a)   The Department of Human Services shall promulgate rules setting
 minimum standards and metrics governing the quality of care provided by a
 regulated facility to a child.
      (b)   Quality of care standards shall include that a regulated facility
 shall provide:
            (1)    Trauma-informed programming and clinical services and, when
 applicable, evidence-based treatments;
            (2)    Services that will be short-term, target treatment episodes
 to reduce the likelihood of re-entry into residential treatment settings;
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     As Engrossed:       H3/13/23 H3/15/23 S4/5/23                                  HB1446
               (3)    Services that are family-driven and youth-guided;
               (4)    Mental health services and clinical services provided by
 clinical staff as appropriate for the child’s needs;
               (5) Educational services in compliance with state and federal law
 and rules of the Department of Education;
               (6)    Coordination of all needs including medical, dental, and
 other needs; and
               (7)    Clinical discharge planning throughout the child’s stay that
 includes the custodian and child involvement.
      (c)(1)      The Department of Human Services and its designees may inspect
 and investigate the quality of care for behavioral health provided to any
 child admitted to a regulated facility, whether or not the child is an
 Arkansas resident.
               (2)    The Department of Human Services or any other public agency
 having authority or responsibility with respect to child maltreatment,
 including without limitation the Medicaid Fraud Control Unit of the Attorney
 General's office, may investigate any alleged or suspected child maltreatment
 in any regulated facility.
      (d)   The Department of Human Services shall conduct quality assurance
 reviews for each regulated facility, consisting of the following:
               (1)    A review of treatment structure including without
 limitation:
                       (A)   Observation of paraprofessional and direct-care staff
 interaction with patients;
                       (B)   Review of daily activity structure outside of school
 and treatment;
                       (C)   Review of paraprofessional and direct-care staff
 training and personnel records;
                       (D)   Review of staff-to-client ratios; and
                       (E)   Completion of client interviews;
               (2)    An analysis of referral data, statistics, and psychotropic
 medication prescriptions;
               (3)    An on-site visit of a regulated facility’s operation, to be
 conducted at least once per year; and
               (4)    Technical assistance and ongoing quality assurance and
 collaboration as needed.
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     As Engrossed:      H3/13/23 H3/15/23 S4/5/23                                  HB1446
      (e)     This subchapter does not require any additional licensure or
 certification for a regulated facility.
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      9-28-1303.       Department enforcement authority.
      (a)     The Department of Human Services may initiate an adverse action
 against a regulated facility that:
              (1)    Fails to comply with the provisions of this subchapter or
 any rule of the department relating to quality of care;
              (2)    Furnishes or makes any statement or report to the department
 that is false or misleading;
              (3)    Refuses or fails to submit required reports or to make
 available to the department any records required by the department in making
 an investigation of the agency for quality of care purposes;
              (4)    Refuses or fails to submit to an investigation or to
 reasonable inspection by the department;
              (5)    Retaliates against an employee who in good faith reports a
 suspected violation of the provisions of this subchapter or the rules
 promulgated under this subchapter;
              (6)    Fails to engage in a course of professional conduct in
 dealing with clients being served by the regulated facility, as defined by
 rules promulgated under this subchapter; or
              (7)    Demonstrates gross negligence in carrying out the duties at
 the regulated facility.
      (b)     The department may impose an adverse action as follows:
              (1)    Issue letters of reprimand or caution;
              (2)    Require a corrective action plan; and
              (3)(A)     Impose civil penalties of up to two thousand five hundred
 dollars ($2,500) per violation, with each day of noncompliance and each
 client injured as a result of noncompliance constituting a separate
 violation.
                       (B)   If any person upon whom the department has levied a
 civil penalty fails to pay the civil penalty within sixty (60) days of the
 decision of the department to impose the penalty, the amount of the fine
 shall be considered to be a debt owed the State of Arkansas and may be
 collected by civil action.
                       (C)   Civil penalties collected under this section may be
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     As Engrossed:       H3/13/23 H3/15/23 S4/5/23                               HB1446
 expended only for the purpose of providing technical assistance and training
 to regulated facilities.
      (c)(1)     For a regulated facility licensed under the Child Welfare
 Agency Licensing Act, § 9-28-401 et seq., the department may petition the
 Child Welfare Agency Review Board to deny, suspend, or revoke the regulated
 facility’s license on the basis of any adverse action imposed by the
 department under this section.
               (2)    For a regulated facility licensed under § 20-9-201 et seq.,
 the department may petition the State Board of Health to deny, suspend, or
 revoke the regulated facility’s license on the basis of any adverse action
 imposed by the department under this section.
      (d)   The department shall notify the regulated facility of the adverse
 action of the department in writing and set forth the facts forming the basis
 for the adverse action.
      (e)(1)     Adverse action hearings shall comply with the Arkansas
 Administrative Procedure Act, § 25-15-201 et seq.
               (2)    Within ten (10) business days after rendering a decision,
 the department shall forward to the regulated facility written findings of
 fact and conclusions of law articulating the decision of the department.
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      9-28-1304.       Rules.
      The Department of Human Services shall promulgate rules to implement
 this subchapter.
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                                      /s/Cavenaugh
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                                    APPROVED: 4/13/23
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Statutes affected: 
Old version HB1446 Original - 2-16-2023 10:54 AM: 9-28-402(12), 9-28-402(18), 9-28-407(a)