20-2-101. Definitions.

As used in this subchapter:

1. “Commission” means the Arkansas Minority Health Commission; and
2. “Minority” means black Americans, Hispanic Americans, Asian Americans, and American Indians.

History. Acts 1991, No. 912, § 1.

20-2-102. Creation — Members.

1. There is established the Arkansas Minority Health Commission to consist of twelve (12) members to be appointed as follows:
   1. Six (6) members of the general public to be appointed by the Governor, with each of the four (4) congressional districts represented;
   2. Three (3) members to be appointed by the President Pro Tempore of the Senate; and
   3. Three (3) members to be appointed by the Speaker of the House of Representatives.
2. All persons appointed to the commission shall be persons who have actively participated in health issues for minorities or have special knowledge or experience with minority health issues.
3. The members shall serve staggered two-year terms.
4. 1. The commission shall meet at least quarterly and at such other times as necessary to carry out its duties under this chapter.
   2. The commission shall elect one (1) of its members as chair and may provide by appropriate adoption of bylaws and rules for the time, place, and manner of calling its meetings.
5. Any state agency, state-supported hospital, or state medical school shall submit to the commission any information the commission requests that relates to health issues for minorities except for names, addresses, telephone numbers, or any other identifying information.

History. Acts 1991, No. 912, §§ 2, 4, 5; 1997, No. 250, § 176; 2001, No. 1288, § 15; 2007, No. 827, § 144; 2009, No. 574, § 1.

Amendments. The 2009 amendment deleted (a)(4) through (a)(7), (e), and (f) and redesignated accordingly; and in (a), substituted “Six (6) members” for “Four (4)” in (a)(1), and substituted “Three (3)” for “Two (2)” in (a)(2) and (a)(3).

20-2-103. Powers and duties generally.

1. The Arkansas Minority Health Commission shall:
   1. Establish the commission as the comprehensive commission in this state for:
      1. Gathering and analyzing information regarding disparities in health and health care and access to health and healthcare services in this state;
      2. Statewide educational programming regarding disparities in health and health care and equal access to health and healthcare services; and
      3. Coordinating events regarding disparities in health and health care and access to health and healthcare services;
   2. 1. Actively seek out and develop partnerships and collaboration with other appropriate organizations to advance the understanding of and access to programs to remediate disparities in health and health care and access to health and healthcare services in this state.
      2. The following health and healthcare-related state entities and divisions of state entities shall collaborate with the commission to achieve healthcare equity in the State of Arkansas:
         1. The Department of Health;
         2. The Department of Human Services;
         3. The Division of Environmental Quality;
         4. The Fay W. Boozman College of Public Health of the University of Arkansas for Medical Sciences; and
         5. The Arkansas Center for Health Improvement.
      3. Partnerships developed by the commission shall connect all experts, agencies, and organizations concerned with minority health issues and minority health events;
   3. Address and make specific recommendations relating to public policy issues involving disparities in health and health care and equity to health and healthcare services for minorities to appropriate agencies, the General Assembly, and the Governor;
   4. Promote public awareness and public education encouraging Arkansans to live healthy lifestyles through awareness of various health and healthcare issues with an emphasis on factors that disproportionately affect the minority population in this state;
   5. Make recommendations to the relevant agencies, to the Secretary of the Department of Health, and to the General Assembly for improving the delivery of and access to health services for minorities;
   6. Gather and analyze information and make recommendations as to whether adequate services are available to ensure that future minority health needs will be met;
   7. 1. Develop, implement, maintain, and disseminate a comprehensive survey of racial and ethnic minority disparities in health and health care.
      2. The commission shall repeat the study every five (5) years to include without limitation disparities arising from geographic location and economic conditions; and
   8. Publish evidence-based data, define state goals and objectives, and develop pilot projects for decreasing disparities under subdivision (a)(7)(A) of this section.
2. The commission shall report two (2) times each year to the House Committee on Public Health, Welfare, and Labor and the Senate Committee on Public Health, Welfare, and Labor.

History. Acts 1991, No. 912, § 3; 2009, No. 358, § 1; 2009, No. 574, § 1; 2013, No. 1132, § 1; 2019, No. 910, §§ 4919-4921.

Amendments. The 2009 amendment by No. 574 rewrote the section.

The 2013 amendment substituted “equal access” for “equity” in (a)(1)(B).

The 2019 amendment substituted the second occurrence of “commission” for “agency” in the introductory language of (a)(1); in the introductory language of (a)(2)(B), substituted “entities” for “agencies” twice; substituted “Division of Environmental Quality” for “Arkansas Department of Environmental Quality” in (a)(2)(B)(iii); substituted “Secretary of the Department of Health” for “Governor” in (a)(5); and made a stylistic change.

20-2-104. Reimbursement for expenses.

1. Members of the Arkansas Minority Health Commission shall serve without pay, but those members not employed by the State of Arkansas may receive expense reimbursement in accordance with § 25-16-901 et seq.
2. The commission may authorize expense reimbursement for its members performing official duties of the commission by a majority vote of its total membership cast at its first regularly scheduled meeting of each calendar year.
3. Any expense reimbursement shall not exceed the rate established for state employees in the state travel rules.

History. Acts 1995, No. 1017, § 3; 1997, No. 250, § 177; 2003, No. 229, § 3; 2007, No. 827, § 145; 2019, No. 315, § 1801.

Amendments. The 2019 amendment substituted “rules” for “regulations” in (c).

20-2-105. Cash fund.

1. There is created a cash fund entitled “Minority Health Commission Cash Fund” to be used for expenses of the Arkansas Minority Health Commission as appropriated by the General Assembly.
2. The commission may receive grants and donations made to the commission or amounts received as reimbursement for producing or reproducing literature or reports, which shall be deposited into the State Treasury as cash funds and may be used for reimbursements for expenses of providing seminars or educational activities.

History. Acts 2005, No. 1405, § 2.

20-2-106. Report on health disparities.

On or before October 1 each year, the Arkansas Minority Health Commission shall report to the Secretary of the Department of Health, the Speaker of the House of Representatives, the President Pro Tempore of the Senate, the Chair of the House Committee on Public Health, Welfare, and Labor, and the Chair of the Senate Committee on Public Health, Welfare, and Labor without limitation:

1. Summarizing the previous year's work under § 20-2-103(a)(5) and (6);
2. Describing reductions in disparities in health and health care in this state; and
3. Outlining plans for continuing and expanding in the coming year the program to reduce disparities in health and health care in this state.

History. Acts 2009, No. 358, § 2; 2019, No. 389, § 1; 2019, No. 910, § 4922.

Publisher's Notes. This section, concerning the Arkansas Commission on Human Resources, was repealed by Acts 1991, No. 343, § 9. The section was derived from Acts 1977, No. 954, § 5; A.S.A. 1947, § 6-1505.

This section was formerly codified as § 20-2-107 and was renumbered as § 20-2-106 by Acts 2019, No. 389, §§ 1, 2.

Former § 20-2-106, concerning the Arkansas Commission on Human Resources, was repealed by Acts 1991, No. 343, § 9. The section was derived from Acts 1977, No. 954, § 5; A.S.A. 1947, § 6-1505.

Amendments. The 2019 amendment by No. 910 substituted “Secretary of the Department of Health” for “Governor” in the introductory language.

20-2-107. [Transferred.]

Publisher's Notes. This section was renumbered as § 20-2-106 by Acts 2019, No. 389, §§ 1, 2.

20-3-101. Title.

This chapter shall be known and may be cited as the “Achieving a Better Life Experience Program Act”.

History. Acts 2015, No. 1238, § 1.

20-3-102. Purpose.

It is the intent and purpose of this chapter to create and establish the Achieving a Better Life Experience Program as provided under the Tax Increase Prevention Act of 2014, Pub. L. No. 113-295.

History. Acts 2015, No. 1238, § 1.

U.S. Code. Division B, Title I of the Tax Increase Prevention Act of 2014, Pub. L. No. 113-295, concerns qualified ABLE programs. Division B, Title I enacted 26 U.S.C. § 529A, amended 26 U.S.C. §§ 529, 4973, 6693; 5 U.S.C. § 552a; and 11 U.S.C. §§ 521, 541, 707, and made conforming amendments.

20-3-103. Definitions.

As used in this chapter:

1. “ABLE account” means an account:
   1. Established by an eligible individual;
   2. Owned by the eligible individual; and
   3. Maintained under this subchapter;
2. “Contracting state” means a state without a qualified ABLE program that has entered into a contract with Arkansas to provide residents of the contracting state access to a qualified ABLE program;
3. “Designated beneficiary” means the eligible individual who established an ABLE account and is the owner of the ABLE account;
4. “Disability certification” means, with respect to an individual, a certification to the satisfaction of the United States Secretary of the Treasury by the individual or the parent or guardian of the individual that:
   1. Certifies that:
      1. 1. 1. The individual has a medically determinable physical or mental impairment that:
               1. Results in marked and severe functional limitations; and
               2. Can be expected to result in death; or
            2. Has lasted or can be expected to last for a continuous period of not less than twelve (12) months; or
         2. The individual is blind within the meaning of § 1614(a)(2) of the Social Security Act; and
      2. The blindness or disability occurred before the individual attained twenty-six (26) years of age; and
   2. Includes a copy of the individual's diagnosis relating to the individual's relevant impairment or impairments, signed by a physician meeting the criteria of § 1861(r)(1) of the Social Security Act;
5. “Eligible individual” means an individual who for a taxable year:
   1. Is entitled to benefits based on blindness or disability under Title II or Title XVI of the Social Security Act, 42 U.S.C. § 301 et seq., and the blindness or disability is a preexisting condition that occurred before the date on which the individual attained twenty-six (26) years of age; or
   2. Has a disability certification filed with the United States Secretary of the Treasury for the taxable year;
6. “Member of the family” means a brother, sister, stepbrother, or stepsister;
7. “Nonqualified distribution” means a distribution from an ABLE account that is not used to pay a qualified disability expense; and
8. “Qualified disability expense” means an expense related to an eligible individual's blindness or disability that is made for the benefit of the eligible individual who is the designated beneficiary, including without limitation the following expenses:
   1. Assistive technology and personal support services;
   2. Education;
   3. Employment training and support;
   4. Expenses for oversight and monitoring;
   5. Financial management and administrative services;
   6. Funeral and burial expenses;
   7. Health, prevention, and wellness expenses;
   8. Housing;
   9. Legal fees;
   10. Transportation; and
   11. Other expenses that are adopted by rule and consistent with the purposes of this chapter.

History. Acts 2015, No. 1238, § 1.

U.S. Code. Section 1614(a)(2) of the Social Security Act, referred to in this section, is codified as 42 U.S.C. § 1382c(a)(2).

Section 1861(r)(1) of the Social Security Act is codified as 42 U.S.C. § 1395x(r)(1).

Titles II and XVI of the Social Security Act are codified as 42 U.S.C. § 401 et seq., and 42 U.S. C. § 1381 et seq., respectively.

20-3-104. Creation of Achieving a Better Life Experience Program Trust.

1. The Achieving a Better Life Experience Program Trust is created.
2. The cotrustees of the trust shall be the Secretary of the Department of Human Services, the Director of Arkansas Rehabilitation Services, and the Treasurer of State.

History. Acts 2015, No. 1238, § 1; 2019, No. 910, § 5172.

Amendments. The 2019 amendment substituted “Secretary of the Department of Human Services” for “Director of the Department of Human Services” in (b).

20-3-105. Achieving a Better Life Experience Program Committee — Administration — Authority — Powers.

1. This chapter shall be administered by the Achieving a Better Life Experience Program Committee, which shall be composed of:
   1. The Secretary of the Department of Human Services, or his or her designee;
   2. The Director of Arkansas Rehabilitation Services, or his or her designee; and
   3. The Treasurer of State, or his or her designee.
2. The Treasurer of State shall:
   1. Manage the Achieving a Better Life Experience Program Trust under § 20-3-104 for the committee;
   2. Provide office space, staff, and materials for the committee;
   3. Perform other services necessary to implement this chapter; and
   4. Conduct outreach and engage in financial educational activities with individuals with disabilities, stakeholders within the community of individuals with disabilities, and their support system.
3. The committee shall adopt rules necessary to administer this chapter and to ensure compliance with the Achieving a Better Life Experience Program as provided under the Tax Increase Prevention Act of 2014, Pub. L. No. 113-295 and federal regulations under the Tax Increase Prevention Act of 2014, Pub. L. No. 113-295.
4. The committee shall:
   1. Establish, develop, implement, and maintain the Achieving a Better Life Experience Program in a manner consistent with this chapter and an Achieving a Better Life Experience program as provided under the Tax Increase Prevention Act of 2014, Pub. L. No. 113-295, and obtain the benefits provided by an Achieving a Better Life Experience program as provided under the Tax Increase Prevention Act of 2014, Pub. L. No. 113-295, for the Achieving a Better Life Experience Program, account owners, and designated beneficiaries;
   2. Adopt rules for the general administration of the Achieving a Better Life Experience Program;
   3. Maintain, invest, and reinvest the funds contributed into the Achieving a Better Life Experience Program consistent with the investment restrictions established by the committee and the standard of care described in the prudent investor rule under § 24-2-611; and
   4. 1. Make and enter into contracts, agreements, or arrangements and retain, employ, and contract for the services of financial institutions, depositories, consultants, broker-dealers, investment advisors or managers, third-party plan administrators, and research, technical, and other services necessary or desirable for carrying out the purposes of this chapter.
      2. Contracts entered into by the committee may be for a term of one to ten (1-10) years.

History. Acts 2015, No. 1238, § 1; 2017, No. 324, § 1; 2019, No. 910, § 5173.

Amendments. The 2017 amendment rewrote (b).

The 2019 amendment substituted “Secretary of the Department of Human Services” for “Director of the Department of Human Services” in (a)(1); and substituted “Division of Workforce Services” for “Department of Career Education” following “Arkansas Rehabilitation Services of the” in (a)(2).

U.S. Code. Division B, Title I of the Tax Increase Prevention Act of 2014, Pub. L. No. 113-295, concerns qualified ABLE programs. Division B, Title I enacted 26 U.S.C. § 529A, amended 26 U.S.C. §§ 529, 4973, 6693; 5 U.S.C. § 552a; and 11 U.S.C. §§ 521, 541, 707, and made conforming amendments.

20-3-106. Rules.

Rules adopted under this chapter shall ensure that:

1. 1. A rollover from an ABLE account does not apply to an amount paid or distributed from the ABLE account to the extent that, not later than the sixtieth day after the date of the payment or distribution, the amount received is paid into another ABLE account for the benefit of the same designated beneficiary or an eligible individual who is a member of the family of the designated beneficiary; and
   2. The limitation under subdivision (1)(A) of this section does not apply to a transfer if the transfer occurs within twelve (12) months after the date of a previous transfer under this chapter for the benefit of the designated beneficiary;
2. A person may make contributions for a taxable year for the benefit of an individual who is an eligible individual for the taxable year to an ABLE account that is established to meet the qualified disability expenses of the designated beneficiary of the ABLE account;
3. A designated beneficiary is limited to one (1) ABLE account;
4. An ABLE account may be established only for a designated beneficiary who is a resident of Arkansas or a resident of a contracting state; and
5. Other requirements of this chapter shall be met.

History. Acts 2015, No. 1238, § 1.

20-3-107. Investment direction.

Except as permitted under the Achieving a Better Life Experience Program as provided under the Tax Increase Prevention Act of 2014, Pub. L. No. 113-295, a person shall not direct the investment of any contributions to or earnings from the program more than two (2) times each year.

History. Acts 2015, No. 1238, § 1.

U.S. Code. Division B, Title I of the Tax Increase Prevention Act of 2014, Pub. L. No. 113-295, concerns qualified ABLE programs. Division B, Title I enacted 26 U.S.C. § 529A, amended 26 U.S.C. §§ 529, 4973, 6693; 5 U.S.C. § 552a; and 11 U.S.C. §§ 521, 541, 707, and made conforming amendments.

20-3-108. ABLE accounts.

1. 1. An account owner or contributor may establish an ABLE account by making an initial contribution to the Achieving a Better Life Experience Program, signing an application form approved by the Achieving a Better Life Experience Program Committee, and naming the ABLE account owner and the designated beneficiary.
   2. If the contributor is not the ABLE account owner, the ABLE account owner shall also sign the application form.
   3. Any person may make contributions to an ABLE account after the ABLE account is opened.
2. Contributions to an ABLE account shall be made only in cash.
3. 1. Total contributions to all ABLE accounts shall not exceed those reasonably necessary to provide for the qualified disability expenses of the beneficiary.
   2. The committee shall establish maximum contribution limits applicable to program ABLE accounts in accordance with the program as provided under the Tax Increase Prevention Act of 2014, Pub. L. No. 113-295.
4. 1. Separate records and accounting shall be required by the program for each ABLE account.
   2. Reports shall be made no less frequently than annually to the ABLE account owner.
5. 1. The program may collect application, ABLE account, or administrative fees to defray the costs of the program.
   2. The application, ABLE account, or administrative fees shall be approved by the committee.

History. Acts 2015, No. 1238, § 1.

U.S. Code. Division B, Title I of the Tax Increase Prevention Act of 2014, Pub. L. No. 113-295, concerns qualified ABLE programs. Division B, Title I enacted 26 U.S.C. § 529A, amended 26 U.S.C. §§ 529, 4973, 6693; 5 U.S.C. § 552a; and 11 U.S.C. §§ 521, 541, 707, and made conforming amendments.

20-3-109. Naming of designated beneficiary and transfers of ABLE accounts.

1. An ABLE account owner shall have the right to name the designated beneficiary of an ABLE account and at any time to change the designated beneficiary of an ABLE account to an eligible individual who is a member of the family of the former designated beneficiary.
2. At the direction of an ABLE account owner, all or a portion of an ABLE account may be transferred to another ABLE account whose designated beneficiary is a member of the family of the designated beneficiary of the transferee ABLE account if the transferee ABLE account was created by this chapter or in accordance with an Achieving a Better Life Experience program as provided under the Tax Increase Prevention Act of 2014, Pub. L. No. 113-295.
3. 1. Unless prohibited by federal law, upon the death of a designated beneficiary, proceeds from an account may be transferred to:
      1. The estate of a designated beneficiary; or
      2. An account for another eligible individual specified by the designated beneficiary or the estate of the designated beneficiary.
   2. An agency or instrumentality of the state shall not seek payment under 26 U.S.C. § 529A(f), as in effect on January 1, 2019, from the account or its proceeds for benefits provided to a designated beneficiary.

History. Acts 2015, No. 1238, § 1; 2019, No. 59, § 1.

Amendments. The 2019 amendment added (c).

U.S. Code. Division B, Title I of the Tax Increase Prevention Act of 2014, Pub. L. No. 113-295, concerns qualified ABLE programs. Division B, Title I enacted 26 U.S.C. § 529A, amended 26 U.S.C. §§ 529, 4973, 6693; 5 U.S.C. § 552a; and 11 U.S.C. §§ 521, 541, 707, and made conforming amendments.

20-3-110. Prohibitions.

1. Total contributions to the ABLE account established on behalf of a particular designated beneficiary in excess of those reasonably necessary to meet the designated beneficiary's qualified disability expenses are prohibited.
2. 1. An ABLE account or a legal or beneficial interest in an ABLE account shall not be assignable, pledged, or otherwise used to secure or obtain a loan or other advancement.
   2. An ABLE account or a legal or beneficial interest in an ABLE account is not subject to attachment, levy, or execution by a creditor of an ABLE account owner or designated beneficiary.

History. Acts 2015, No. 1238, § 1.

20-3-111. Funds exempt from tax.

1. Except as otherwise indicated in this chapter, interest, dividends, and capital gains from funds invested in the Achieving a Better Life Experience Program are exempt from Arkansas income taxes.
2. 1. A qualified distribution from a disability savings account established under the Achieving a Better Life Experience Program is exempt from Arkansas income tax with respect to the designated beneficiary's income.
   2. 1. Nonqualified distributions from a disability savings account established under the Achieving a Better Life Experience Program are subject to Arkansas income tax.
      2. The nonqualified distribution is taxable to the party, account owner, or designated beneficiary who actually makes the withdrawal.
3. Earnings on a contribution that are included in a refund are subject to Arkansas income tax if an account owner receives a refund of contributions to a disability savings account established under the Achieving a Better Life Experience Program because of either:
   1. The death or disability of the designated beneficiary; or
   2. A scholarship, allowance, or payment described in 26 U.S.C. § 135(d)(1)(B) or (d)(1)(C), as in effect on January 1, 2014, received by the designated beneficiary.
4. 1. Contributions to a disability savings account established under this chapter may be deducted from the taxpayer's adjusted gross income for the purpose of calculating Arkansas income tax under § 26-51-403(b).
   2. Deductible contributions under this subsection shall not exceed five thousand dollars ($5,000) per taxpayer in a tax year.
   3. A contribution that has been deducted from a taxpayer's income for a prior tax year under this subsection is subject to recapture if the taxpayer:
      1. Takes a subsequent nonqualified distribution from the account; or
      2. Rolls the account over to a tax-deferred savings program established by another state or institution under 26 U.S.C. § 529A.
   4. A contribution that is subject to recapture under this subsection shall be recaptured by adding the amount previously deducted, not to exceed the amount of the nonqualified distribution, to the taxpayer's adjusted gross income for the tax year in which the nonqualified distribution occurred.

History. Acts 2015, No. 1238, § 1; 2019, No. 825, § 1.

Amendments. The 2019 amendment added (d).

Effective dates. Acts 2019, No. 825, § 2: “effective for tax years beginning on or after January 1, 2019”.

20-3-112. Limitation on liability.

Neither the Achieving a Better Life Experience Program, the Achieving a Better Life Experience Program Committee and each of its members, nor the state shall:

1. Insure any ABLE account or guarantee any rate of return or any interest rate on any contribution;
2. Be liable for any loss incurred by any person as a result of participating in the program under this chapter; or
3. Be deemed to be a guarantor of a positive return on a contribution under this chapter.

History. Acts 2015, No. 1238, § 1.

20-3-113. Liberal construction.

This chapter shall be liberally construed to comply with the requirements of the Achieving a Better Life Experience Program as provided under the Tax Increase Prevention Act of 2014, Pub. L. No. 113-295.

History. Acts 2015, No. 1238, § 1.

U.S. Code. Division B, Title I of the Tax Increase Prevention Act of 2014, Pub. L. No. 113-295, concerns qualified ABLE programs. Division B, Title I enacted 26 U.S.C. § 529A, amended 26 U.S.C. §§ 529, 4973, 6693; 5 U.S.C. § 552a; and 11 U.S.C. §§ 521, 541, 707, and made conforming amendments.

Subchapter 1 — Arkansas Healthcare Decisions Act

A.C.R.C. Notes. Acts 2013, No. 1264, § 2, provided: “The State Board of Health shall adopt the following forms and may by rule revise the forms so long as the revisions are consistent with the intent of this act.”FORMS

Click to view

20-6-101. Title.

This subchapter shall be known and may be cited as the “Arkansas Healthcare Decisions Act”.

History. Acts 2013, No. 1264, § 1.

20-6-102. Definitions.

As used in this subchapter:

1. “Advance directive” means an individual instruction or a written statement that anticipates and directs the provision of health care for an individual, including without limitation a living will or a durable power of attorney for health care;
2. “Agent” means an individual designated in an advance directive to make a healthcare decision for the individual granting the power;
3. “Capacity” means an individual's ability to understand the significant benefits, risks, and alternatives to proposed health care and to make and communicate a healthcare decision;
4. 1. “Durable power of attorney for health care” means a written advance directive that identifies an agent who is authorized to make healthcare decisions on behalf of the principal.
   2. “Durable power of attorney for health care” includes without limitation a document appointing a healthcare proxy executed under § 20-17-202;
5. “Emancipated minor” means a minor who has been emancipated under § 9-27-362;
6. “Emergency responder” means a paid or volunteer firefighter, law enforcement officer, or other public safety official or volunteer acting within the scope of his or her proper function or rendering emergency care at the scene of an emergency;
7. “Guardian” means a judicially appointed guardian or conservator having authority to make a healthcare decision for an individual;
8. “Health care” means any care, treatment, service, or procedure to maintain, diagnose, treat, or otherwise affect an individual's physical or mental condition, including medical care;
9. “Healthcare decision” means consent, refusal of consent, or withdrawal of consent to health care;
10. 1. “Healthcare institution” means an agency, institution, facility, or place, whether publicly or privately owned or operated, that provides healthcare services, medical treatment, or nursing or rehabilitative care to a person.
    2. “Healthcare institution” includes without limitation:
       1. An ambulatory surgical facility;
       2. A birthing center;
       3. A home health agency;
       4. A hospital;
       5. An intermediate care facility for individuals with intellectual disabilities;
       6. A mental health center;
       7. An assisted living facility;
       8. A nursing home;
       9. An outpatient diagnostic center;
       10. A residential treatment facility;
       11. A rehabilitation facility; and
       12. A hospice;
11. “Healthcare provider” means a person who is licensed, certified, or otherwise authorized by the laws of this state to administer health care in the ordinary course of the practice of his or her profession;
12. “Individual instruction” means an individual's direction concerning a healthcare decision for the individual;
13. 1. “Living will” means a written advance directive describing the principal's individual instructions for health care to be provided or withheld if the principal subsequently lacks decision-making capacity.
    2. “Living will” includes without limitation a declaration executed under § 20-17-202;
14. “Medical care” means the diagnosis, cure, mitigation, treatment, or prevention of disease for the purpose of affecting any structure or function of the body;
15. “Person” means an individual, corporation, estate, trust, partnership, association, joint venture, government, governmental subdivision, agency, instrumentality, or any other legal or commercial entity;
16. “Person authorized to consent on the principal's behalf” means:
    1. A person authorized by law to consent on behalf of the principal when the principal is incapable of making an informed decision; or
    2. In the case of a minor child, the parent or parents having custody of the child, the child's legal guardian, or another person as otherwise provided by law;
17. “Personally inform” means to communicate by any effective means from the principal directly to a healthcare provider;
18. “Physician” means an individual authorized to practice medicine or osteopathy in this state;
19. “Principal” means an individual who grants authority to another individual under this subchapter;
20. “Qualified emergency medical service personnel” includes without limitation emergency medical technicians, paramedics, or other emergency services personnel, providers, or entities acting within the usual course of their professions, and other emergency responders;
21. “Reasonably available” means readily able to be contacted without undue effort and willing and able to act in a timely manner considering the urgency of the principal's healthcare needs, including without limitation availability by telephone;
22. “State” means a state of the United States, the District of Columbia, the Commonwealth of Puerto Rico, or a territory or insular possession subject to the jurisdiction of the United States;
23. “Supervising healthcare provider” means a licensed physician or other authorized independent healthcare provider who has undertaken primary responsibility for an individual's health care;
24. “Surrogate” means an individual, other than a principal's agent or guardian, authorized under this subchapter to make a healthcare decision for the principal; and
25. “Treating healthcare provider” means a healthcare provider who is directly or indirectly involved in providing health care to the principal.

History. Acts 2013, No. 1264, § 1; 2017, No. 974, § 1.

Amendments. The 2017 amendment deleted former (4), (17), and (25) and inserted the definitions for “Durable power of attorney for health care”, “Emancipated minor”, and “Living will” and redesignated the remaining subdivisions accordingly; deleted “for health care” following “directive” in (2); rewrote (10); substituted “another individual” for “an individual” in (19); and substituted “a licensed physician or other authorized independent” for “the designated physician or, if there is no designated physician or the designated physician is not reasonably available, the” in (23).

20-6-103. Oral or written individual instructions — Advance directive for health care — When effective — Decisions based on best interest assessment — Out-of-state directives — Construction.

1. 1. 1. An adult, married minor, or emancipated minor may make healthcare decisions for himself or herself and give an individual instruction.
      2. A person who is authorized to consent on behalf of a principal may make healthcare decisions for the principal and may give an individual instruction.
   2. The instruction may be oral or written.
   3. The instruction may be limited to take effect only if a specified condition arises.
2. 1. An adult, married minor, or emancipated minor may execute a durable power of attorney for health care that authorizes an agent to make a healthcare decision that the principal could make if he or she had capacity.
   2. A durable power of attorney for health care shall be in writing and signed by the principal.
   3. A durable power of attorney for health care remains in effect notwithstanding the principal's latest incapacity and may include a living will or other individual instructions.
3. 1. An advance directive, including without limitation a living will or durable power of attorney for health care, shall be either notarized or witnessed by two (2) witnesses.
   2. For the purposes of this subsection, a witness shall be a competent adult who is not the agent, and at least one (1) of the witnesses is not related to the principal by blood, marriage, or adoption and would not be entitled to any portion of the estate of the principal upon the death of the principal under any will or codicil made by the principal existing at the time of execution of the advance directive or by operation of law.
   3. A written advance directive, including without limitation a living will or durable power of attorney for health care, that is witnessed shall contain an attestation clause that attests that the witnesses comply with this subsection.
   4. A written advance directive may include the principal's nomination of a guardian of the principal.
4. Unless otherwise specified in an advance directive, the authority of an agent becomes effective only upon a determination that the principal lacks capacity and ceases to be effective upon a determination that the principal has recovered capacity.
5. 1. If necessary, a licensed physician shall determine whether a principal lacks or has recovered capacity or that another condition exists that affects an individual instruction or the authority of an agent.
   2. In making a determination under subdivision (e)(1) of this section, a licensed physician may consult with other persons as he or she deems appropriate.
6. 1. An agent shall make a healthcare decision in accordance with the principal's individual instructions and other wishes to the extent known to the agent.
   2. 1. In the absence of individual instructions or other information, the agent shall make the decision in accordance with the agent's determination of the principal's best interest.
      2. In determining the principal's best interest, the agent shall consider the principal's personal values to the extent known to the agent.
7. A healthcare decision made by an agent for a principal is effective without judicial approval.
8. An advance directive that is executed outside of this state shall be given effect in this state if, at the time of execution, the advance directive complies with either this subchapter or the laws of the state in which the advance directive was executed.
9. A healthcare provider, healthcare institution, healthcare service plan, insurer issuing disability insurance, self-insured employee welfare benefit plan, or nonprofit hospital plan shall not require the execution or revocation of an advance directive as a condition of the principal's being insured for or receiving health care.

History. Acts 2013, No. 1264, § 1; 2017, No. 974, § 1.

Amendments. The 2017 amendment rewrote the section.

20-6-104. Revocation of designation of agent — Revocation of advance directive — Spouse as agent — Conflicts.

1. A principal having capacity may revoke all or part of an advance directive, including without limitation a living will, durable power of attorney for health care, or other document, at any time and in any manner that communicates an intent to revoke.
2. A decree of annulment, divorce, dissolution of marriage, or legal separation revokes a previous designation of a spouse as agent unless otherwise specified in the decree or in an advance directive.
3. An advance directive that conflicts with an earlier advance directive revokes the earlier advance directive to the extent of the conflict.
4. A healthcare provider, agent, guardian, or surrogate who is informed of a revocation shall promptly communicate the fact of the revocation to the supervising healthcare provider and any healthcare institution at which the patient is receiving care.

History. Acts 2013, No. 1264, § 1; 2017, No. 974, § 1.

Amendments. The 2017 amendment substituted “including without limitation a living will, durable power of attorney for health care, or other document” for “other than the designation of an agent” in (a); deleted former (b) and redesignated the remaining subsections accordingly; and added (d).

20-6-105. Designation of surrogate.

1. 1. An adult, married minor, or emancipated minor may designate an individual to act as surrogate by personally informing the supervising healthcare provider.
   2. The designation may be oral or written.
2. A surrogate may make a healthcare decision for a principal who is an adult or emancipated minor only if:
   1. The principal has been determined by a licensed physician to lack capacity; and
   2. An agent or guardian has not been appointed or the agent or guardian is not reasonably available.
3. 1. The supervising healthcare provider shall identify a surrogate for the principal and document the appointment in the clinical record of the institution or institutions at which the principal is receiving health care if the principal:
      1. Lacks capacity;
      2. Has not appointed an agent or the agent is not reasonably available;
      3. Has not designated a surrogate or the surrogate is not reasonably available; and
      4. Does not have a guardian or the guardian is not reasonably available.
   2. 1. The principal's surrogate shall be an adult who:
         1. Has exhibited special care and concern for the principal;
         2. Is familiar with the principal's personal values;
         3. Is reasonably available; and
         4. Is willing to serve.
      2. A person who is the subject of a protective order or other court order that directs that person to avoid contact with the principal is not eligible to serve as the principal's surrogate.
   3. In identifying the person best qualified to serve as the surrogate for the principal, the supervising healthcare provider:
      1. Shall consider the proposed surrogate's:
         1. Ability to make decisions either in accordance with the known wishes of the principal or in accordance with the principal's best interests;
         2. Frequency of contact with the principal before and during the incapacitating illness; and
         3. Demonstrated care and concern; and
      2. May consider the proposed surrogate's:
         1. Availability to visit the principal during his or her illness; and
         2. Availability to fully participate in the decision-making process.
   4. When identifying the person best qualified to serve as the surrogate for the principal, the supervising healthcare provider may proceed in order of descending preference for service as a surrogate to:
      1. The principal's spouse, unless legally separated;
      2. The principal's adult child;
      3. The principal's parent;
      4. The principal's adult sibling;
      5. Any other adult relative of the principal; or
      6. Any other adult person who satisfies the requirements of subdivision (c)(2) of this section.
   5. If none of the individuals eligible to act as a surrogate under this subsection are reasonably available and informed consent would typically be sought from the principal, the supervising healthcare provider may make healthcare decisions for the principal after the supervising healthcare provider:
      1. Consults with and obtains the recommendations of an institution's ethics officers or ethics committee; or
      2. Obtains concurrence from a second physician who is:
         1. Not directly involved in the principal's health care;
         2. Does not serve in a capacity of decision making, influence, or responsibility over the designated physician; and
         3. Does not serve in a capacity under the authority of the designated physician's decision making, influence, or responsibility.
   6. 1. In the event of a challenge to the identification of the surrogate or the authority of the surrogate to act, it is a rebuttable presumption that the selection of the surrogate was valid.
      2. A person who challenges the selection of the surrogate has the burden of proving the invalidity of that selection by a preponderance of the evidence.
4. 1. Except as provided in subdivision (d)(2) of this section:
      1. Neither the treating healthcare provider nor an employee of the treating healthcare provider, nor an operator of a healthcare institution, nor an employee of an operator of a healthcare institution may be designated as a surrogate; and
      2. A healthcare provider or employee of a healthcare provider may not act as a surrogate if the healthcare provider becomes the principal's treating healthcare provider.
   2. An employee of the treating healthcare provider or an employee of an operator of a healthcare institution may be designated as a surrogate if:
      1. The employee so designated is a relative of the principal by blood, marriage, or adoption; and
      2. The other requirements of this section are satisfied.
5. A healthcare provider may require an individual claiming the right to act as surrogate for a principal to provide a written declaration under penalty of perjury stating facts and circumstances reasonably sufficient to establish the claimed authority.

History. Acts 2013, No. 1264, § 1; 2017, No. 974, § 1.

Amendments. The 2017 amendment inserted “married minor” in (a)(1); substituted “a licensed” for “the designated” in (b)(1); substituted “identify” for “designate” in the introductory language of (c)(1); rewrote (c)(3); substituted “When identifying the person best qualified to serve as the surrogate for the principal, the supervising healthcare provider may proceed” for “Consideration may be given” in (c)(4); added (c)(4)(F); rewrote the introductory language of (c)(5); inserted “or ethics committee” in (c)(5)(A); and substituted “identification” for “designation” in (c)(6)(A).

20-6-106. Authority of surrogate.

1. 1. A surrogate shall make a healthcare decision in accordance with the principal's individual instructions, if any, and other wishes to the extent known to the surrogate.
   2. 1. Otherwise, the surrogate shall make the decision in accordance with the surrogate's determination of the principal's best interest.
      2. In determining the principal's best interest, the surrogate shall consider the principal's personal values to the extent known to the surrogate or agent.
2. A surrogate who has not been designated by the principal may make all healthcare decisions for the principal that the principal could make on the principal's own behalf, except that artificial nutrition and hydration may be withheld or withdrawn for a principal upon a decision of the surrogate only if:
   1. The action is authorized by the a living will or other written advance directive; or
   2. The supervising healthcare provider and a second independent physician certify in the principal's current clinical records that:
      1. The provision or continuation of artificial nutrition or hydration is merely prolonging the act of dying; and
      2. The principal is highly unlikely to regain capacity to make medical decisions.
3. A healthcare decision made by a surrogate or agent for a principal is effective without judicial approval.

History. Acts 2013, No. 1264, § 1; 2017, No. 974, § 1.

Amendments. The 2017 amendment added “or agent” in (a)(2)(B); redesignated part of the former introductory language of (b) as (b)(2); added (b)(1); substituted “The supervising healthcare provider” for “the designated physician” in (b)(2); redesignated former (b)(1) and (b)(2) as (b)(2)(A) and (b)(2)(B); and inserted “or agent” in (c).

20-6-107. Requirement of guardian to comply with principal's individual instruction.

1. Absent a court order to the contrary, a guardian shall comply with the principal's individual instructions and shall not revoke the principal's advance directive.
2. Except as provided in § 28-65-102, a healthcare decision made by a guardian for the principal is effective without judicial approval.

History. Acts 2013, No. 1264, § 1; 2017, No. 974, § 1.

Amendments. The 2017 amendment inserted “of guardian” in the section heading; and added “Except as provided in § 28-65-102” in (b).

20-6-108. Determination of capacity.

If a licensed physician makes a determination or is informed of a determination that a principal lacks or has recovered capacity or that another condition exists that affects an individual instruction or the authority of an agent, guardian, or surrogate, the licensed physician shall:

1. Record promptly the determination in the principal's current clinical record; and
2. Communicate the determination to the principal, if possible, and to any person authorized to make healthcare decisions for the principal.

History. Acts 2013, No. 1264, § 1; 2017, No. 974, § 1.

Amendments. The 2017 amendment substituted “licensed” for “designated” twice in the introductory language.

20-6-109. Compliance by healthcare provider or institution.

1. Except as provided in subsections (b)-(d) of this section, a healthcare provider or institution providing care to a principal shall comply with:
   1. An individual instruction of the principal and with a reasonable interpretation of that instruction by a person authorized to make healthcare decisions for the principal; and
   2. A healthcare decision for the principal made by a person authorized to make healthcare decisions for the principal to the same extent as if the decision had been made by the principal while having capacity.
2. A healthcare provider may decline to comply with an individual instruction or healthcare decision for reasons of conscience.
3. A healthcare institution may decline to comply with an individual instruction or healthcare decision if the instruction or decision:
   1. Is contrary to a policy of the institution that is based on reasons of conscience; and
   2. The policy was timely communicated to the principal or to a person authorized to make healthcare decisions for the principal.
4. A healthcare provider or institution may decline to comply with an individual instruction or healthcare decision that requires medically inappropriate health care or health care contrary to generally accepted healthcare standards applicable to the healthcare provider or institution.
5. A healthcare provider or institution that declines to comply with an individual instruction or healthcare decision under subsection (b), subsection (c), or subsection (d) of this section shall:
   1. Inform promptly the principal, if possible, or a person authorized to make healthcare decisions for the principal;
   2. Provide continuing care to the principal until a transfer can be effected or until a determination has been made that a transfer cannot be effected; and
   3. 1. Unless the principal or person authorized to make healthcare decisions for the principal refuses assistance, immediately make all reasonable efforts to assist in the transfer of the principal to another healthcare provider or healthcare institution that is willing to comply with the instruction or decision.
      2. If a transfer cannot be effected, the healthcare provider or institution shall not be compelled to comply.

History. Acts 2013, No. 1264, § 1.

20-6-110. Disclosure of medical or other healthcare information.

Unless otherwise specified in an advance directive, a person authorized to make healthcare decisions for a principal has the same rights as the principal to request, receive, examine, copy, and consent to the disclosure of medical or any other healthcare information.

History. Acts 2013, No. 1264, § 1.

20-6-111. Liability.

1. A healthcare provider or healthcare institution acting in good faith and in accordance with generally accepted healthcare standards applicable to the healthcare provider or healthcare institution is not subject to civil or criminal liability or to discipline for unprofessional conduct for:
   1. Complying with a healthcare decision of a person apparently having authority to make a healthcare decision for a principal, including a decision to withhold or withdraw health care;
   2. Declining to comply with a healthcare decision of a person based on a reasonable belief that the person then lacked authority; or
   3. Complying with an advance directive that, to the knowledge of the healthcare provider or healthcare institution, was valid when made and has not been revoked or terminated.
2. An individual acting as agent or surrogate under this subchapter is not subject to civil or criminal liability or to discipline for unprofessional conduct for healthcare decisions made in good faith.
3. A person who designates a surrogate under this subchapter is not subject to civil or criminal liability or to discipline for unprofessional conduct for a designation made in good faith.

History. Acts 2013, No. 1264, § 1.

20-6-112. Presumption of capacity.

1. This subchapter does not affect the right of an individual to make healthcare decisions while having capacity to do so.
2. An individual is presumed to have capacity to make a healthcare decision, to give or revoke an advance directive, and to designate or disqualify a surrogate.

History. Acts 2013, No. 1264, § 1.

20-6-113. Copies have same effect as originals.

A copy of a written advance directive, revocation of an advance directive, or designation or disqualification of a surrogate has the same effect as the original.

History. Acts 2013, No. 1264, § 1.

20-6-114. Presumptions not created — Death that results from withholding or withdrawal of health care does not constitute suicide, euthanasia, homicide, mercy killing, or assisted suicide.

1. This subchapter does not create a presumption concerning the intention of an individual who has not made or who has revoked an advance directive.
2. Notwithstanding any term of an insurance policy or annuity to the contrary, a death resulting from the withholding or withdrawal of health care in accordance with this subchapter does not constitute a suicide or homicide or legally impair or invalidate an insurance policy or an annuity providing a death benefit.
3. The withholding or withdrawal of medical care from a principal in accordance with this subchapter does not constitute a suicide, euthanasia, homicide, mercy killing, or assisted suicide.

History. Acts 2013, No. 1264, § 1.

20-6-115. Court jurisdiction.

1. A court of competent jurisdiction may enjoin or direct a healthcare decision or order other equitable relief on a petition of:
   1. A principal;
   2. A principal's agent, guardian, or surrogate;
   3. A healthcare provider or healthcare institution involved with the principal's care; or
   4. An individual described in § 20-6-106(b).
2. A proceeding under this section shall be expedited on the court's civil dockets.

History. Acts 2013, No. 1264, § 1.

20-6-116. Effect and interpretation of living wills.

1. If a living will entered into before October 1, 2013, was valid at the time of execution, it remains valid.
2. A living will entered into on or after October 1, 2013, that evidences an intent that it is entered into under this subchapter is valid.
3. A living will entered into on or after October 1, 2013, that does not evidence an intent that it is entered into under this subchapter may be given effect as an individual instruction if it complies with this subchapter.

History. Acts 2013, No. 1264, § 1.

20-6-117. Effect and interpretation of durable powers of attorney.

1. If a durable power of attorney for health care entered into before October 1, 2013, was valid at the time of execution, it remains valid.
2. A durable power of attorney for health care entered into on or after October 1, 2013, that evidences an intent that it is entered into under this subchapter is valid.
3. A durable power of attorney for health care entered into on or after October 1, 2013, that does not evidence an intent that it is entered into under this subchapter may be given effect as an advance directive under this subchapter if it complies with this subchapter.

History. Acts 2013, No. 1264, § 1.

20-6-118. [Repealed.]

Publisher's Notes. This section, concerning the repeal of conflicting laws, was repealed by Acts 2017, No. 974, § 2. The section was derived from Acts 2013, No. 1264, § 1.

Subchapter 2 — Patient Right-to-Know Act

Effective Dates. Acts 2017, No. 754, § 2: Mar. 30, 2017. Emergency clause provided: “It is found and determined by the General Assembly of the State of Arkansas that healthcare providers are often unable to obtain information about their patients when the healthcare providers terminate relationships with certain entities and relocate their practices; that patients are often unable to locate their healthcare providers due to efforts by certain entities to hinder access; that the Patient Right-to-Know Act will prohibit this activity and require certain entities to inform patients of the new practice location and new contact information of their healthcare providers; and that this act is immediately necessary to ensure continuity of care and prevent disruption of healthcare provider-patient relationships. Therefore, an emergency is declared to exist, and this act being immediately necessary for the preservation of the public peace, health, and safety shall become effective on: (1) The date of its approval by the Governor; (2) If the bill is neither approved nor vetoed by the Governor, the expiration of the period of time during which the Governor may veto the bill; or (3) If the bill is vetoed by the Governor and the veto is overridden, the date the last house overrides the veto.”

20-6-201. Title.

This subchapter shall be known and may be cited as the “Patient Right-to-Know Act”.

History. Acts 2017, No. 754, § 1.

20-6-202. Legislative findings and purpose.

1. The General Assembly finds that:
   1. Patients are entitled to continuity of care with their healthcare providers;
   2. Healthcare providers are prohibited legally and ethically from abandoning a patient before treatment has been concluded;
   3. When a healthcare provider changes practice locations, steps are necessary to ensure that the patient's continuity of care and the legal and ethical obligations of the healthcare provider are fulfilled; and
   4. Patients should be informed about any change in the practice location of their treating healthcare provider and should not be prevented from receiving this type of information.
2. The purpose of this subchapter is to remove and prevent impediments to patients' maintaining continuity of care and keeping their treatment relationship with their chosen healthcare provider.

History. Acts 2017, No. 754, § 1.

20-6-203. Definitions.

As used in this subchapter:

1. 1. “Entity” means any person, organization, or business entity of any type that engages a healthcare provider as an employee, independent contractor, member, or in any other capacity for the practice of medicine as defined in § 17-95-202.
   2. “Entity” does not include insurance companies, health maintenance organizations, or hospital and medical service corporations;
2. 1. “Existing patient” means a person who is seen for a medical diagnosis or treatment, or both, by a healthcare provider within the previous twelve (12) months as evidenced by an entry in the medical record of the patient.
   2. The twelve-month period described in subdivision (2)(A) of this section shall be calculated by counting back twelve (12) months from the later of the following dates:
      1. The date that the healthcare provider's relationship with the entity terminates; or
      2. The date that the healthcare provider gave the entity notice of a new practice location; and
3. “Healthcare provider” means a person who:
   1. Is licensed by:
      1. The Arkansas State Medical Board;
      2. The Arkansas State Board of Dental Examiners;
      3. The Arkansas State Board of Nursing;
      4. The Arkansas State Board of Chiropractic Examiners;
      5. The Arkansas Board of Podiatric Medicine; or
      6. The State Board of Optometry; and
   2. Has ultimate responsibility and legal liability for the care of the patient.

History. Acts 2017, No. 754, § 1.

20-6-204. Prohibited conduct.

1. If the healthcare provider has made new practice location information or new contact information available to the entity, an entity or person on behalf of an entity shall not:
   1. Mislead any patient about the new practice location of a healthcare provider or new contact information of a healthcare provider; or
   2. Fail to provide a patient with the new practice location of a healthcare provider or new contact information of a healthcare provider when requested.
2. 1. When requested by a healthcare provider who is relocating his or her practice, an entity with a relationship with the healthcare provider shall within twenty-one (21) calendar days:
      1. Provide the healthcare provider with a list of the healthcare provider's existing patient names and addresses;
      2. Send a notice with the new practice location information to all of the healthcare provider's existing patients after providing the healthcare provider a copy of the proposed notice for review and comment; or
      3. 1. Post the new practice location information of the healthcare provider on the website of the entity after providing the healthcare provider a copy of the proposed posting for review and comment.
         2. The posting shall remain on the website of the entity for twelve (12) months after the healthcare provider's last day of employment with the entity posting the information.
   2. Within two (2) business days of the request described in subdivision (b)(1) of this section, the entity shall provide the healthcare provider with a list or schedule of upcoming patient appointments with the healthcare provider and the contact information of the patients.

History. Acts 2017, No. 754, § 1.

20-6-205. Affirmative defense in medical injury cases.

If patient abandonment or other medical injury occurs due to a violation by an entity of this subchapter, the violation shall be an affirmative defense for the physician in a claim brought by the injured patient who shall be entitled to bring a claim against the entity.

History. Acts 2017, No. 754, § 1.

20-6-206. Injunctive relief.

1. An affected patient or healthcare provider may file an action seeking an injunction of a violation of this subchapter in the circuit court of:
   1. Pulaski County;
   2. The county in which the healthcare provider has his or her practice located;
   3. The county in which the affected patient resides; or
   4. The county in which the entity is located.
2. Upon the filing of a complaint, the court may issue a temporary injunction on the violation without notice or bond.
3. If the plaintiff patient or healthcare provider establishes that this subchapter has been violated, the court may enter an order permanently enjoining the violation of this subchapter or otherwise enforcing compliance with this subchapter.
4. A prevailing plaintiff shall be entitled to:
   1. The greater of liquidated damages in the amount of one thousand dollars ($1,000) per day per violation, or actual damages; and
   2. Reasonable attorney's fees and costs.
5. A violation of this subchapter shall constitute an unfair and deceptive act or practice as defined under the Deceptive Trade Practices Act, § 4-88-101 et seq.

History. Acts 2017, No. 754, § 1.

20-6-207. Applicability — Construction.

1. This subchapter:
   1. Applies to any express or implied contract, agreement, or understanding entered into, renewed, modified, or extended on or after March 30, 2017; and
   2. Does not amend or repeal any portion of the Medical Corporation Act, § 4-29-301 et seq., or the Dental Corporation Act, § 4-29-401 et seq.
2. Any purported waiver of the benefits or requirements of this subchapter is void and against the public policy of this state.

History. Acts 2017, No. 754, § 1.

Subchapter 3 — Arkansas Physician Order for Life-Sustaining Treatment Act

A.C.R.C. Notes. Acts 2017, No. 504, § 2, provided: “The State Board of Health shall adopt the following form and may by rule revise the form so long as the revisions are consistent with the intent of this act.”

Click to view

20-6-301. Title.

This subchapter shall be known and may be cited as the “Arkansas Physician Order for Life-Sustaining Treatment Act”.

History. Acts 2017, No. 504, § 1.

20-6-302. Legislative findings.

The General Assembly finds that:

1. It is important for individuals to make healthcare decisions before a medical crisis or emergency occurs;
2. Healthcare planning is a process, rather than a single decision, that helps individuals think about the type of care that they would want if they become seriously ill or incapacitated, and encourages individuals to talk with their loved ones and physicians regarding their healthcare decisions;
3. An advance directive gives individuals the ability to put their wishes in writing and to identify another individual who would speak for them if they become unable to speak or make decisions for themselves;
4. The physician order for life-sustaining treatment form complements an advance directive, if existing, by taking an individual's intentions regarding life-sustaining treatment, such as the intentions set forth in an advance directive, and converting the individual's intentions into a medical order;
5. The hallmarks of a physician order for life-sustaining treatment form are that a physician order for life-sustaining treatment form:
   1. Is:
      1. Signed;
      2. Immediately actionable as medical orders on a standardized form;
      3. A conspicuous, clearly identifiable form; and
      4. Recognized, adopted, and honored across treatment settings; and
   2. Addresses a range of life-sustaining treatment interventions as well as the patient's preferred intensity of treatment for each intervention; and
6. The physician order for life-sustaining treatment form is used only for patients with a serious illness or medical frailty when a physician would not be surprised if the patient died within one (1) year.

History. Acts 2017, No. 504, § 1.

20-6-303. Definitions.

As used in this subchapter:

1. 1. “Healthcare facility” means an institution, building, agency, or a portion of an institution, building, or agency that is used, operated, or designed to provide healthcare services, medical treatment, nursing care, rehabilitative care, or preventative care to an individual, regardless of whether the institution, building, or agency is a private organization, a public organization, a nonprofit organization, or a for-profit organization.
   2. “Healthcare facility” includes without limitation:
      1. An ambulatory surgical facility;
      2. A home health agency;
      3. A hospice;
      4. A hospital;
      5. An infirmary;
      6. A long-term care facility;
      7. An assisted living facility;
      8. A mental health center;
      9. An outpatient facility;
      10. A rehabilitation facility; and
      11. A residential treatment facility;
2. “Healthcare provider” means an individual who is licensed, certified, or otherwise authorized or permitted by the laws of this state to administer health care in the ordinary course of business or in the practice of a profession, including without limitation:
   1. An emergency medical care provider; and
   2. An individual providing home and community-based services;
3. “Legal representative” means the same as a person authorized to consent on the principal's behalf under § 20-6-102;
4. “Patient” means an individual who has a critical medical condition or a terminal illness and for whom a physician has determined that a physician order for life-sustaining treatment is consistent with the individual's goals of care;
5. “Physician” means an individual who is licensed to practice medicine or osteopathic medicine in this state; and
6. “Physician order for life-sustaining treatment” means a document containing orders by a physician regarding life-sustaining treatment and medical interventions in accordance with the wishes of a patient, or if the wishes of the patient are not reasonably known and cannot with reasonable diligence be ascertained, in accordance with the best interest of the patient.

History. Acts 2017, No. 504, § 1.

20-6-304. Physician order for life-sustaining treatment form.

1. The State Board of Health shall prescribe a standardized physician order for life-sustaining treatment form that:
   1. Is signed and dated by:
      1. The patient or the legal representative of the patient; and
      2. The physician of the patient;
   2. Includes:
      1. The name and date of birth of the patient; and
      2. The intentions of the patient regarding care, including without limitation the administration of cardiopulmonary resuscitation and the level of medical interventions in the event of a medical emergency; and
   3. Is easily distinguishable to facilitate recognition by healthcare providers and healthcare facilities.
2. A legal representative may sign a physician order for life-sustaining treatment form on behalf of a patient who lacks capacity to do so, guided by:
   1. The express or implied intentions of the patient; or
   2. If the intentions of the patient are unknown and cannot be reasonably determined, the best interest of the patient given the overall medical condition and prognosis of the patient.
3. 1. The physician order for life-sustaining treatment form shall be completed by a physician based upon patient intentions and medical indications.
   2. During the process of completing the physician order for life-sustaining treatment form, the physician may:
      1. Explain:
         1. The physician order for life-sustaining treatment form; and
         2. The medical interventions and procedures offered by the life-sustaining treatment form; and
      2. Inform the patient or the legal representative of the patient about the difference between an advance directive and the physician order for life-sustaining treatment form.
4. This subchapter does not authorize a physician to unilaterally create a physician order for life-sustaining treatment on behalf of an individual.

History. Acts 2017, No. 504, § 1.

20-6-305. Compliance.

1. Except as provided in subsection (c) of this section, a healthcare provider and a healthcare facility shall treat a patient in accordance with the physician order for life-sustaining treatment form.
2. A physician order for life-sustaining treatment form is valid in a healthcare facility, regardless of whether the physician who signed the life-sustaining treatment form has clinical privileges at the healthcare facility.
3. 1. A healthcare provider or healthcare facility is not required to comply with a physician order for life-sustaining treatment form if the physician order for life-sustaining treatment form requires medically ineffective health care or health care contrary to generally accepted healthcare standards applicable to a healthcare provider or healthcare facility.
   2. A healthcare provider or healthcare facility may decline to comply with an executed physician order for life-sustaining treatment form based upon religious beliefs or moral convictions if the healthcare provider or healthcare facility:
      1. Promptly informs the patient or legal representative of the patient regarding the inability to carry out the physician order for life-sustaining treatment form;
      2. Provides continuing care to the patient until a transfer can be made or a determination has been made that the transfer cannot be made; and
      3. 1. Makes all reasonable efforts to assist in the prompt transfer of the patient to another healthcare provider or healthcare facility that is willing to comply with the executed physician order for life-sustaining treatment form.
         2. If a transfer cannot be made, the healthcare provider or healthcare facility shall not be compelled to comply with the physician order for life-sustaining treatment form.
   3. This section does not authorize a healthcare provider or healthcare facility to withhold life-sustaining treatment against the wishes of a patient or a legal representative.

History. Acts 2017, No. 504, § 1.

20-6-306. Review and revision.

1. 1. An executed physician order for life-sustaining treatment form may be reviewed periodically by the physician of the patient.
   2. The physician may:
      1. Conduct an evaluation of the patient; and
      2. In consultation with the patient or the legal representative of the patient, issue a new physician order for life-sustaining treatment form consistent with the most current information available about the health status and goals of care of the patient.
2. 1. The new physician order for life-sustaining treatment form shall be:
      1. Recorded on a new physician order for life-sustaining treatment form; and
      2. Signed in compliance with § 20-6-304.
   2. Once a new physician order for life-sustaining treatment form has been executed, the previous physician order for life-sustaining treatment form shall be nullified.
3. A patient with the capacity to make his or her own healthcare decisions may, at any time, request alternative treatment to the treatment that was ordered on the physician order for life-sustaining treatment form.
4. The legal representative of the patient who does not have the capacity to make his or her own healthcare decisions shall consult with the physician who is the treating physician of the patient before making a request to modify the orders reflected in the physician order for life-sustaining treatment form of the patient.

History. Acts 2017, No. 504, § 1.

20-6-307. Relationship with advance directives.

1. 1. A physician order for life-sustaining treatment form is not intended to replace an advance directive.
   2. In executing a physician order for life-sustaining treatment form, a patient, the legal representative of the patient when applicable, and the physician shall make a good-faith effort to locate and incorporate treatment preferences documented in a previously executed advance directive, when appropriate and desired by the patient.
2. In the event of a conflict with a physician order for life-sustaining treatment form and an advance directive, either:
   1. The document executed most recently by the patient shall take precedence regarding the medical decision or treatment preference at issue; or
   2. If both the advance directive and the physician order for life-sustaining treatment form were executed by the legal representative of the patient, the advance directive shall take precedence regarding the medical decision or treatment preference at issue.
3. This section does not prohibit or require the execution, revocation, or modification of an advance directive.

History. Acts 2017, No. 504, § 1.

20-6-308. Liability.

A healthcare provider, healthcare facility, or employee or agent of the healthcare provider or healthcare facility is not subject to civil or criminal liability or discipline for unprofessional conduct for:

1. Complying with a physician order for life-sustaining treatment form based upon a good-faith assumption that the physician order for life-sustaining treatment form was valid when executed and that the physician order for life-sustaining treatment form was not revoked or terminated;
2. Failing to comply with a physician order for life-sustaining treatment form based upon a good faith determination that:
   1. The physician order for life-sustaining treatment form was not valid; or
   2. The physician order for life-sustaining treatment form requires medically ineffective health care or health care contrary to generally accepted healthcare standards applicable to the healthcare provider or healthcare facility; or
3. Declining to comply with an executed physician order for life-sustaining treatment form based upon religious beliefs or moral convictions if the healthcare provider or healthcare facility complies with the requirements of § 20-6-305.

History. Acts 2017, No. 504, § 1.

20-6-309. Voluntary signing.

1. The signing of a physician order for life-sustaining treatment form by a patient or legal representative of the patient is voluntary.
2. 1. A person or entity, including without limitation a healthcare provider, healthcare facility, employer, or health insurance carrier, shall not require an individual to execute a physician order for life-sustaining treatment form as a condition of being insured for, or receiving, healthcare services.
   2. If a healthcare provider or healthcare facility complies with subdivision (b)(1) of this section, the healthcare provider or healthcare facility may have a policy to offer a physician order for life-sustaining treatment form to appropriate individuals as part of a conversation about:
      1. Goals of care;
      2. Personal values and preferences;
      3. Benefits of various treatment options; and
      4. Avoidance of unwanted burden.
3. This subchapter does not:
   1. Create a presumption concerning the intention of an individual who has not executed a physician order for life-sustaining treatment form with respect to the use, withholding, or withdrawal of life-sustaining procedures in the event of a terminal condition; or
   2. Affect the right of an individual to make decisions regarding the use of life-sustaining procedures as long as the individual has the capacity to make a decision.

History. Acts 2017, No. 504, § 1.

20-6-310. Criminal penalty.

1. It is unlawful for a person to knowingly:
   1. Conceal, cancel, deface, obliterate, or damage a physician order for life-sustaining treatment form without the consent of the patient or the legal representative of the patient;
   2. 1. Cause an individual to execute a physician order for life-sustaining treatment form by undue influence, fraud, or duress.
      2. As used in this section, “undue influence” includes without limitation:
         1. Charging a different rate or fee for insurance coverage or healthcare services based upon whether the individual consents to a physician order for life-sustaining treatment form or has executed a physician order for life-sustaining treatment form;
         2. Requiring a healthcare provider to have an internal policy to offer a physician order for life-sustaining treatment form to any individual;
         3. Providing any financial incentive, payment, discount, or rating incentive for having an internal policy or procedure relating to the completion of a physician order for life-sustaining treatment form as applied to a healthcare provider or healthcare facility; or
         4. Imposing a rating or reimbursement penalty if a healthcare provider or healthcare facility fails to achieve a target for physician order for life-sustaining treatment form completions; or
   3. Falsify or forge a physician order for life-sustaining treatment form of another person that results in a direct change of health care provided to the patient.
2. A person who violates this section is guilty of a Class D felony.
3. This section does not prevent payment to a healthcare provider or healthcare facility for consultation with or counseling of a patient concerning a physician order for life-sustaining treatment form or for offering advance directive healthcare planning.

History. Acts 2017, No. 504, § 1.

20-6-311. Applicability — Death — Life insurance.

1. A death that results from compliance with a physician order for life-sustaining treatment form does not constitute a suicide, homicide, or abuse, for any reason.
2. 1. The execution of a physician order for life-sustaining treatment form does not affect the sale, procurement, or issuance of a life insurance policy or annuity policy.
   2. A life insurance policy or annuity policy shall not be impaired or invalidated if emergency care or life-sustaining treatment is withheld from an insured individual who has executed a physician order for life-sustaining treatment form.
3. This subchapter does not:
   1. Condone, authorize, or approve mercy killing, euthanasia, or physician-assisted suicide; or
   2. Permit any affirmative or deliberate act or omission to end life other than to permit the natural process of dying.

History. Acts 2017, No. 504, § 1.

20-6-312. Copy of physician order for life-sustaining treatment form.

A copy of an executed physician order for life-sustaining treatment form has the same effect as the original physician order for life-sustaining treatment form.

History. Acts 2017, No. 504, § 1.

Subchapter 1 — General Provisions

A.C.R.C. Notes. Acts 2005, No. 1954, § 4, provided:

“State Board of Health.

“(a) Effective at 12:01 AM on July 1, 2005, the State Board of Health is transferred to the Department of Health and Human Services.

“(b) For the purposes of this act, the State Board of Health shall receive administrative support from the Division of Health of the Department of Health and Human Services but shall retain exactly the same powers, authorities, duties, and functions prescribed by law as it had prior to the transfer and shall have all rule- and regulation-making authority prescribed by law to the Department of Health before the transfer, except as provided for in this act, including, but not limited to:

“(1) Rule making, regulation, licensing, and registration;

“(2) The promulgation of rules, rates, regulations, and standards;

“(3) Examinations, investigations, inspections, and reviews; and

“(4) The rendering of findings, orders, and adjudications.”

Acts 2007, No. 384, § 1, provided:

“Creation of the Department of Health.

“(a) There is created the Department of Health, that is to be established if the Governor orders the separation of the Division of Health of the Department of Health and Human Services from the Department of Health and Human Services.

“(b) If the Governor establishes the Department of Health under subsection (a) of this section, the Arkansas Code Revision Commission shall replace all references in the Arkansas Code to the:

“(1) ‘Division of Health of the Department of Health and Human Services’ or ‘Division of Health’ with ‘Department of Health’; and

“(2) ‘Department of Health and Human Services’ with ‘Department of Human Services’.

“(c) Sections 2 through 12 of this act become effective only if the Governor establishes the Department of Health under subsection (a) of this section.”

Acts 2007, No. 384, § 2, provided:

“Transfer of the Division of Health of the Department of Health and Human Services out of the Department of Health and Human Services.

“(a) Effective sixty (60) days after the Governor establishes the Department of Health under this act, and as provided in the orders of the Governor, the following may be transferred to the Department of Health:

“(1) Authority, powers, duties, and functions as established by law for the Division of Health of the Department of Health and Human Services, including purchasing, budgeting, fiscal, accounting, human resources, payroll, legal, information systems, maintenance, program support, administrative support, and other management functions;

“(2) Records, personnel, property, unexpended balances of appropriations, allocations, or other funds of the Division of Health of the Department of Health and Human Services;

“(3) Rulemaking, regulation, and licensing, promulgation of rules, rates, regulations, and standards, and the rendering of findings, orders, and adjudications as established by law for the Division of Health of the Department of Health and Human Services, except as otherwise specified in this act.

“(b) Powers, duties, and functions, including without limitation, rulemaking, regulation, and licensing, promulgation of rules, rates, regulations, and standards, budgetary responsibilities, and the rendering of findings, orders, and adjudications as established by law for the Breast Cancer Control Program or other transferred entities within the Division of Health of the Department of Health and Human Services shall be retained as they existed on June 30, 2005.

“(c) The Governor may appoint a Surgeon General in accordance with § 20-7-103.”

Acts 2007, No. 384, § 3, provided:

“Transfer of the State Board of Health to the Department of Health.

“(a) Effective sixty (60) days after the Department of Health is established, the State Board of Health shall be transferred to the Department of Health.

“(b) The State Board of Health shall receive administrative support from the Department of Health and shall retain the same powers, authorities, duties, and functions prescribed by law as it had before the transfer and shall have all rule-making authority prescribed by law to the Division of Health of the Department of Health and Human Services before the transfer, except as provided for in this act, including, without limitation:

“(1) Rule making, licensing, and registration;

“(2) The promulgation of rules, rates, and standards;

“(3) Examining, investigating, inspecting, and reviewing; and

“(4) The rendering of findings, orders, and adjudications.”

Publisher's Notes. Because of the enactment of Subchapter 2 of this chapter by Acts 1989, No. 749, § 1, the existing provisions of this chapter have been designated as Subchapter 1.

Acts 1993, No. 350, § 7, provided:

“(a) All powers, functions and duties heretofore vested in and exercised by the Health Building Commission are hereby transferred to and shall hereafter be vested in the State Board of Health.

“(b) All funds appropriated to and all property, both real and personal, vested in the Health Building Commission are hereby transferred and shall be made available to the State Board of Health.

“(c) The Health Building Commission is hereby abolished.”

Effective Dates. Acts 1881, No. 85, § 14: effective on passage.

Acts 1895, No. 152, § 5: effective on passage.

Acts 1913, No. 96, § 33: Feb. 25, 1913. Emergency declared.

Acts 1923, No. 92, § 6: Feb. 9, 1923. Emergency clause provided: “This act being necessary for the public peace, health and safety, an emergency is hereby declared and this act shall be in full force and effect from and after its passage and approval by the governor.”

Acts 1929, No. 109, § 3: Mar. 9, 1929. Emergency clause provided: “In view of the fact that the need for the protection of the public health is imperative and the changes herein contemplated are necessary for a more efficient administration of the State Board of Health, the immediate operation of this act is necessary for the preservation of the public peace, health and safety, and this act shall take effect and be in force and effect from and after its passage.”

Acts 1931, No. 235, § 12: Mar. 27, 1931. Emergency clause provided: “This act being necessary for the health and safety of the State shall take effect and be in full force from and after its passage and approval.”

Acts 1949, No. 302, § 5: Mar. 19, 1949. Emergency clause provided: “It appearing to the Legislature that the membership of the State Board of Health as presently constituted does not adequately give representation to those other professions interested and informed in matters of public health, and it appearing that there be an immediate public need for such representation, an emergency is hereby declared to exist, and this act being necessary for the immediate preservation of the public peace, health and safety, shall take effect and be in full force from and after its passage and approval.”

Acts 1953, No. 282, § 3: Mar. 11, 1953. Emergency clause provided: “It is hereby determined by the General Assembly that the law authorizing the employment of an assistant State Health Officer has been inadvertently repealed and that it is essential to the continued operation of the State Health Department that an assistant State Health Officer be authorized, and the passage of this act being immediately necessary for the preservation of the public peace, health and safety shall be in full force and effect from and after its passage and approval.”

Acts 1959, No. 186, § 5: Mar. 6, 1959. Emergency clause provided: “It appearing to the Legislature that the membership of the State Board of Health as presently constituted does not adequately give representation to those other professions interested and informed in matters of public health, and it appearing that there be an immediate public need for such representation, an emergency is hereby declared to exist, and this act being necessary for the immediate preservation of the public peace, health and safety, shall take effect and be in full force from and after its passage and approval.”

Acts 1961, No. 433, § 4: Mar. 15, 1961. Emergency clause provided: “It appearing to the Legislature that the membership of the State Board of Health as presently constituted does not adequately give representation to those other professions interested and informed in matters of public health, and it appearing that there be an immediate public need for such representation, an emergency is hereby declared to exist, and this Act being necessary for the immediate preservation of the public peace, health and safety, shall take effect and be in full force from and after its passage and approval.”

Acts 1965, No. 469, § 27: Mar. 20, 1965. Emergency clause provided: “It is hereby found and declared by the General Assembly that the present building is wholly inadequate to house the State Board of Health, the State Health Officer, the State Department of Health and the divisions, units, agencies, officers and employees thereof, with the result that it is impossible to properly and efficiently carry out functions and duties required by law; that because of such inadequacy the State is not having its health and related needs properly taken care of, all of which is to the detriment of the public health, safety and welfare; and that only by the immediate operation of this Act can these conditions be alleviated. Therefore, an emergency is hereby declared to exist and this Act being necessary for the preservation of the public peace, health and safety, shall take effect and be in full force from and after its passage and approval.”

Acts 1971, No. 204, § 3: Mar. 2, 1971. Emergency clause provided: “The General Assembly having found that one of the major functions of the Board of Health of the State of Arkansas is the inspection of meat and meat products and that the prevention and control of disease in animals is a necessary part of the process of assuring a supply of wholesome meat products and that the presence of a licensed veterinarian on the State Board of Health will contribute greatly to the efficiency and performance of the duties of said Board and that there is an immediate need for the appointment of such licensed veterinarian to the said State Board of Health. An emergency is hereby declared and this Act being necessary for the immediate protection of the public health, safety and welfare shall be in full force and effect immediately upon its passage and approval.”

Acts 1975, No. 383, § 4: Mar. 12, 1975. Emergency clause provided: “It is hereby declared by the General Assembly that only an immediate operation of this Act can correct inequities and rectify problems created for State Health Board Members engaged in functions and duties required by law and alleviate all troublesome conditions associated therewith. Therefore, an emergency is hereby declared to exist and this Act being necessary to the public peace, health and safety shall take effect upon its passage and approval.”

Acts 1977, No. 318, § 3: Mar. 1, 1977. Emergency clause provided: “It is hereby found and determined by the General Assembly that many of the functions and responsibilities of the Board of Health of the State of Arkansas vitally affect the operation and administration of hospital facilities in this State and that the membership on the State Board of Health of a hospital administrator would enhance the State Board of Health's efficiency and ability to deal with issues affecting hospitals while at the same time insuring that the interests of the hospitals are represented, and that there is an immediate need for the appointment of a hospital administrator to the Board of Health. Therefore, an emergency is hereby declared and this Act being necessary for the immediate protection of the public health, safety and welfare shall be in full force and effect immediately upon its passage and approval.”

Acts 1977, No. 889, § 39: July 1, 1977. Emergency clause provided: “It is hereby found and determined by the Seventy-First General Assembly, that the Constitution of the State of Arkansas prohibits the appropriation of funds for more than a two (2) year period; that the effectiveness of this Act on July 1, 1977 is essential to the operation of the agency for which the appropriations in this Act are provided, and that in the event of an extension of the Regular Session, the delay in the effective date of this Act beyond July 1, 1977 could work irreparable harm upon the proper administration and providing of essential governmental programs. Therefore, an emergency is hereby declared to exist and this Act being necessary for the immediate preservation of the public peace, health, and safety shall be in full force and effect from and after July 1, 1977.”

Acts 1979, No. 198, § 3: Feb. 21, 1979. Emergency clause provided: “It is hereby found and determined by the General Assembly of the State of Arkansas that there is an immediate need to establish the most efficient possible administrative structure in the Department of Health. Therefore, an emergency is hereby declared to exist and this Act, being necessary for the immediate preservation of the public peace, health, and safety, shall be in full force and effect from and after its passage and approval.”

Acts 1979, No. 797, § 3: Apr. 10, 1979. Emergency clause provided: “It is hereby found and determined by the General Assembly that the present law prescribing qualifications of the Assistant Director of the Department of Health is unduly restrictive in that it requires such person to be a licensed physician; that this Act is designed to revise such qualifications to require only that the Assistant Director be knowledgeable in the field of public health and should be given effect immediately. Therefore, an emergency is hereby declared to exist and this Act being necessary for the immediate preservation of the public peace, health and safety shall be in full force and effect from and after its passage and approval.”

Acts 1987, No. 146, § 4: Mar. 10, 1987. Emergency clause provided: “It is hereby found and determined by the General Assembly that due to current revenue shortfalls the services offered by the Department of Health to the citizens of this State are threatened; that an equitable method of maintaining these services is to provide for a fee to be paid by those citizens who request the assistance of the State Department of Health; that this Act is designed to provide for the collection of such fees and should be given effect immediately. Therefore, an emergency is hereby declared to exist and this Act being necessary for the immediate preservation of the public peace, health and safety shall be in full force and effect from and after its passage and approval.”

Acts 1987, No. 399, § 4: Mar. 25, 1987. Emergency clause provided: “It is hereby found and determined by the General Assembly that due to current revenue shortfalls the services offered by the Department of Health to the citizens of this State are threatened; that an equitable method of maintaining these services is to provide for additional fees to be paid by those citizens who request the assistance of the State Department of Health; that this Act is designed to provide for the collection of additional fees and should be given effect immediately. Therefore, an emergency is hereby declared to exist and this Act being necessary for the immediate preservation of the public peace, health and safety shall be in full force and effect from and after its passage and approval.”

Acts 1993, No. 350, § 11: Mar. 3, 1993. Emergency clause provided: “It is hereby found and determined by the General Assembly that the Arkansas Department of Health is critically in need of additional space and that, accordingly, the authorization to construct or acquire space enabled by this act, must be obtained as soon as feasible. Therefore, an emergency is hereby declared to exist and this act being necessary for the immediate preservation of the public peace, health and safety shall be in full force and effect from and after its passage and approval.”

Acts 1993, No. 485, § 5: Mar. 12, 1993. Emergency clause provided: “It is hereby found and determined by the General Assembly of the State of Arkansas that the provisions of this Act are immediately necessary due to regulations and requirements of the federal government concerning laboratories which impact public health programs at the Arkansas Department of Health; and that this legislation will permit mid-level professionals to serve patients in public health clinics which will improve the efficiency of clinic operations thereby increasing services to patients. Therefore, an emergency is hereby declared to exist and this act being necessary for the immediate preservation of the public peace, health, and safety, shall be in full force and effect from and after its passage and approval.”

Acts 1995, No. 270, § 19: July 1, 1995. Emergency clause provided: “It is hereby found and determined by the Eightieth General Assembly, that various laws have been enacted since the passage of the Revenue Classification Law which have changed or created various revenues collected by the State, and that this amendment to the Revenue Classification Law is necessary in order to reflect the various taxes, licenses, fees and other revenues levied and collected for the support of and use by State Government as they currently exist and from which appropriations which become effective July 1, 1995 have been made by the Eightieth General Assembly. Therefore, an emergency is hereby declared to exist and this Act being necessary for the immediate preservation of the public peace, health and safety shall be in full force and effect from and after July 1, 1995.”

Acts 1995 (1st Ex. Sess.), No. 13, § 13: Oct. 23, 1995. Emergency clause provided: “It is hereby found and determined by the General Assembly of the State of Arkansas that the current system of funding the state judicial system has created inequity in the level of judicial services available to the citizens of the state; and it is further determined that the current method of financing the state judicial system has become so complex as to make the administration of the system impossible, and the lack of reliable data on the current costs of the state judicial system prohibits any comprehensive change in the funding of the system at this time. Therefore, an emergency is hereby declared to exist and this act being necessary for the immediate preservation of the public peace, health, and safety, shall be in full force and effect from and after its passage and approval.”

Acts 1997, No. 179, § 38: Feb. 17, 1997. Emergency clause provided: “It is hereby found and determined by the General Assembly that Act 10 of the First Extraordinary Session of 1995 abolished the Joint Interim Committee on Public Health, Welfare, and Labor and in its place established the House Interim Committee and Senate Interim Committee on Public Health, Welfare, and Labor; that various sections of the Arkansas Code refer to the Joint Interim Committee on Public Health, Welfare, and Labor and should be corrected to refer to the House and Senate Interim Committees on Public Health, Welfare, and Labor; that this act so provides; and that this act should go into effect immediately in order to make the laws compatible as soon as possible. Therefore, an emergency is declared to exist and this act being immediately necessary for the preservation of the public peace, health and safety shall become effective on the date of its approval by the Governor. If the bill is neither approved nor vetoed by the Governer, it shall become effective on the expiration of the period of time during which the Governor may veto the bill. If the bill is vetoed by the Governor and the veto is overridden, it shall become effective on the date the last house overrides the veto.”

Acts 1997, No. 250, § 258: Feb. 24, 1997. Emergency clause provided: “It is hereby found and determined by the General Assembly that Act 1211 of 1995 established the procedure for all state boards and commissions to follow regarding reimbursement of expenses and stipends for board members; that this act amends various sections of the Arkansas Code which are in conflict with the Act 1211 of 1995; and that until this cleanup act becomes effective conflicting laws will exist. Therefore an emergency is declared to exist and this act being immediately necessary for the preservation of the public peace, health and safety shall become effective on the date of its approval by the Governor. If the bill is neither approved nor vetoed by the Governer, it shall become effective on the expiration of the period of time during which the Governor may veto the bill. If the bill is vetoed by the Governor and the veto is overridden, it shall become effective on the date the last house overrides the veto.”

Acts 1997, No. 396, § 6: Mar. 7, 1997. Emergency clause provided: “It is found and determined by the General Assembly of the State of Arkansas that the current law refers to a certificate of need process from agencies that have been abolished; that this act is necessary to remove the inconsistencies in the law and to provide for a permit of approval; and that this act is immediately necessary for the administration of the law. Therefore, an emergency is declared to exist and this act being immediately necessary for the preservation of the public peace, health and safety shall become effective on the date of its approval by the Governor. If the bill is neither approved nor vetoed by the Governor, it shall become effective on the expiration of the period of time during which the Governor may veto the bill. If the bill is vetoed by the Governor and the veto is overridden, it shall become effective on the date the last house overrides the veto.”

Acts 2003, No. 1723, § 15: Apr. 22, 2003. Emergency clause provided: “It is found and determined by the Eighty-fourth General Assembly that there is a pressing and immediate need for the construction of a modern public health laboratory; that this act will provide adequate funding for the construction of the laboratory; and that this act must become effective immediately. Therefore, an emergency is declared to exist and this act being immediately necessary for the preservation of the public peace, health, and safety shall become effective on: (1) The date of its approval by the Governor; (2) If the bill is neither approved nor vetoed by the Governor, the expiration of the period of time during which the Governor may veto the bill; or (3) If the bill is vetoed by the Governor and the veto is overridden, the date the last house overrides the veto.”

Acts 2007, No. 384, § 11: Mar. 19, 2007. Emergency clause provided: “It is found and determined by the General Assembly of the State of Arkansas that many services delivered by the various divisions, offices, and units the Department of Health and Human Services are essential to the public health, safety, and welfare; that the state fiscal year begins July 1; that beginning the process of decoupling the Division of Health of the Department of Health and Human Services from the Department of Health and Human Services during a fiscal year will cause disruptions of services and unnecessary time, effort, and expense in reallocating appropriations, budgets, personnel, equipment, and capital expenditures during a fiscal year; and that this act is immediately necessary because a delay beyond the beginning of the fiscal year will disrupt essential programs and services. Therefore, an emergency is declared to exist and this act being necessary for the preservation of the public peace, health, and safety shall become effective on: (1) The date of its approval by the Governor; (2) If the bill is neither approved nor vetoed by the Governor, the expiration of the period of time during which the Governor may veto the bill; or (3) If the bill is vetoed by the Governor and the veto is overridden, the date the last house overrides the veto.”

Acts 2019, No. 910, § 6346(b): July 1, 2019. Emergency clause provided: “It is found and determined by the General Assembly of the State of Arkansas that this act revises the duties of certain state entities; that this act establishes new departments of the state; that these revisions impact the expenses and operations of state government; and that the sections of this act other than the two uncodified sections of this act preceding the emergency clause titled ‘Funding and classification of cabinet-level department secretaries’ and ‘Transformation and Efficiencies Act transition team’ should become effective at the beginning of the fiscal year to allow for implementation of the new provisions at the beginning of the fiscal year. Therefore, an emergency is declared to exist, and Sections 1 through 6343 of this act being necessary for the preservation of the public peace, health, and safety shall become effective on July 1, 2019”.

20-7-101. Violations — Penalties.

1. 1. Every firm, person, or corporation violating any of the provisions of this act or any of the orders or rules made and promulgated in pursuance hereof shall be deemed guilty of a misdemeanor and upon conviction thereof shall be punished by a fine of not less than one hundred dollars ($100) nor more than five hundred dollars ($500) or by imprisonment not exceeding one (1) month, or both.
   2. Each day of violation shall constitute a separate offense.
2. 1. 1. 1. Every firm, person, or corporation who violates any of the rules issued or promulgated by the State Board of Health or who violates any condition of a license, permit, certificate, or any other type of registration issued by the board may be assessed a civil penalty by the board. The penalty shall not exceed one thousand dollars ($1,000) for each violation.
         2. Each day of a continuing violation may be deemed a separate violation for purposes of penalty assessments.
      2. However, no civil penalty may be assessed until the person charged with the violation has been given the opportunity for a hearing on the violation.
   2. All fines collected under this subsection shall be deposited into the State Treasury and credited to the Public Health Fund to be used to defray the costs of administering this section.
   3. Subject to such rules as may be implemented by the Chief Fiscal Officer of the State, the disbursing officer for the Department of Health may transfer all unexpended funds relative to fines collected under this subsection, as certified by the Chief Fiscal Officer of the State, to be carried forward and made available for expenditures for the same purpose for any following fiscal year.
   4. All rules promulgated pursuant to this subsection shall be reviewed by the House Committee on Public Health, Welfare, and Labor and the Senate Committee on Public Health, Welfare, and Labor or appropriate subcommittees thereof.

History. Acts 1913, No. 96, § 28; C. & M. Dig., § 5146; Pope's Dig., § 6417; A.S.A. 1947, § 82-121; Acts 1987, No. 146, § 2; 1991, No. 990, §§ 1, 5; 1997, No. 179, § 19; 2019, No. 315, § 1802.

Publisher's Notes. Acts 1913, No. 96, § 28, as amended, is also codified as § 14-262-101.

Amendments. The 2019 amendment substituted “orders or rules” for “orders, rules, or regulations” in (a)(1); deleted “or regulations” following “rules” in (b)(1)(A)(i); and deleted “and regulations” following “rules” in (b)(3) and (b)(4).

Meaning of “this act”. Acts 1913, No. 96, codified as §§ 14-262-101 — 14-262-105, 20-7-101 — 20-7-106, 20-7-109, 20-7-110, 20-7-114, 20-7-118, 20-7-122, 20-7-125.

20-7-102. Members — Appointment.

1. The State Board of Health shall consist of the following members, to be appointed by the Governor subject to confirmation by the Senate as follows:
   1. 1. Seven (7) members of the board shall be licensed medical doctors of good professional standing, to be appointed by the Governor as follows:
         1. One (1) member shall be appointed from each of the four (4) congressional districts of this state as established by § 7-2-101 et seq.; and
         2. Three (3) members shall be appointed from the state at large by the Governor after consulting the Arkansas Medical Society, Inc.
      2. Notwithstanding the provisions of subdivision (a)(1)(A) of this section, at least one (1) of the positions allocated for licensed medical doctors shall be an osteopathic physician appointed by the Governor after consulting the Arkansas Osteopathic Medical Association from the state at large;
   2. One (1) member shall be a regularly licensed, registered, and practicing dentist who has at least seven (7) years' experience in the practice of his or her profession in this state. This member shall be appointed by the Governor after consulting the Arkansas State Dental Association;
   3. One (1) member shall be a professional engineer as defined in § 17-30-101 who has at least seven (7) years' experience in the practice of his or her profession in this state. This member shall be appointed by the Governor after consulting The Arkansas Society of Professional Engineers;
   4. One (1) member shall be a regularly licensed professional nurse who has been a resident of the state for at least seven (7) years preceding the appointment and who has at least a bachelor's degree and five (5) years' nursing experience in the state. This member shall be appointed from a list by the Governor after consulting the Arkansas Nurses Association;
   5. One (1) member shall be a regularly licensed pharmacist who has been actively engaged in the practice of pharmacy for at least seven (7) years preceding his or her appointment. This member shall be appointed by the Governor after consulting the Arkansas Pharmacist's Association;
   6. One (1) member shall be a regularly licensed veterinarian who has been actively engaged in the practice of veterinary medicine for at least seven (7) years preceding his or her appointment. This member shall be appointed by the Governor after consulting the Arkansas Veterinary Medical Association;
   7. One (1) member shall be a registered sanitarian who has at least seven (7) years' experience in the practice of his or her profession preceding his or her appointment. This member shall be appointed by the Governor after consulting the Arkansas State Board of Sanitarians;
   8. One (1) member shall be a hospital administrator who has at least seven (7) years' experience in the practice of his or her profession in Arkansas. This member shall be appointed by the Governor after consulting the Arkansas Hospital Association, Inc.;
   9. One (1) member shall be a regularly licensed, registered, and practicing optometrist who has at least seven (7) years' experience in the practice of his or her profession in this state. This member shall be appointed by the Governor after consulting the Arkansas Optometric Association, Inc.;
   10. One (1) member shall be a regularly licensed and practicing chiropractor. This member shall be appointed by the Governor after consulting the Arkansas Chiropractic Physicians Association;
   11. One (1) member shall be a restaurant operator who has owned or operated a restaurant for a minimum of five (5) years. This member shall be appointed by the Governor after consulting the Arkansas Hospitality Association, Inc.;
   12. One (1) member shall be a consumer representative who has an interest in public health. This member shall be appointed by the Governor from the state at large;
   13. One (1) member shall be more than sixty (60) years of age and represent the elderly. This person shall not be actively engaged in or retired from any occupation, profession, or industry to be regulated by the board. The member shall be appointed by the Governor from the state at large and be subject to confirmation by the Senate;
   14. One (1) member shall be a licensed doctor of podiatric medicine of good professional standing who has at least seven (7) years' experience in the practice of the profession in this state. The member shall be appointed by the Governor after consulting the Arkansas Podiatric Medical Association Inc.;
   15. One (1) member shall be a member of the Arkansas Public Health Association, Inc. The member shall be appointed by the Governor after consulting the Arkansas Public Health Association, Inc.;
   16. One (1) member shall be a licensed medical doctor of good professional standing who shall be appointed by the Governor from a rural county that contains a medically underserved population in the state; and
   17. One (1) member shall be the Secretary of the Department of Health.
2. Each of the members of the board so appointed shall take the oath prescribed by the Arkansas Constitution for state officers and shall be commissioned by the Governor in the same manner as other state officials.

History. Acts 1913, No. 96, §§ 1, 2; C. & M. Dig., §§ 5125, 5126; Acts 1929, No. 109, § 1; Pope's Dig., §§ 6388, 6389; Acts 1949, No. 302, §§ 1, 2; 1959, No. 186, §§ 1, 2; 1961, No. 433, § 1; 1963, No. 240, § 1; 1971, No. 204, § 1; 1975, No. 295, § 1; 1977, No. 318, § 1; 1979, No. 198, § 1; 1981, No. 713, § 1; 1983, No. 131, §§ 1-3, 5; 1983, No. 135, §§ 1-3, 5; A.S.A. 1947, §§ 6-623 — 6-626, 82-101, 82-103; Acts 1987, No. 112, § 1; 1991, No. 829, § 1; 1995, No. 747, § 1; 2003, No. 1450, § 1; 2005, No. 1954, § 5; 2007, No. 384, § 4; 2011, No. 897, § 15; 2015, No. 1100, § 46; 2019, No. 910, § 4923.

Amendments. The 2011 amendment substituted “a professional engineer as defined in § 17-30-101” for “a registered professional engineer” in (a)(3).

The 2015 amendment inserted “subject to confirmation by the Senate” in the introductory language of (a); substituted “by the Governor after consulting” for “from a list of not fewer than three (3) names presented by” and similar language throughout (a); rewrote (a)(10); and inserted “by the Governor” in (a)(16).

The 2019 amendment substituted “Secretary of the Department of Health” for “Director of the Department of Health” in (a)(17).

20-7-103. Members — Officers.

1. The members of the State Board of Health shall elect one (1) of the members as president.
2. 1. The State Board of Health shall nominate to the Governor a Director of the Department of Health.
   2. 1. The Governor shall appoint the director who shall serve at the pleasure of the Governor.
      2. The director shall report to the Secretary of the Department of Health.
      3. The Secretary of the Department of Health may serve as the Director of the Department of Health if the Governor determines all statutory requirements are fulfilled.
   3. The director may:
      1. Serve as the State Health Officer;
      2. Serve as the Secretary for the State Board of Health but shall not sit as a member of the State Board of Health; and
      3. 1. 1. Be a licensed medical doctor who is a graduate of a school of medicine recognized by the Arkansas State Medical Board;
            2. Hold a graduate degree in public health or a graduate degree in a recognized public health discipline from an accredited college or university or have equivalent knowledge and experience in public health as determined by the Secretary of the Department of Health; and
            3. Have experience in the practice of public health and in leadership and management, the sufficiency of which shall be determined by the Secretary of the Department of Health; or
         2. Hold a doctoral degree in public health or a doctoral degree in a recognized public health discipline from an accredited college or university with at least five (5) years of experience in the practice of public health and at least ten (10) years of experience in the leadership and management of a large complex organization, the sufficiency of which shall be determined by the Secretary of the Department of Health.

History. Acts 1913, No. 96, § 2; C. & M. Dig., § 5126; Acts 1929, No. 109, § 1; Pope's Dig., § 6389; Acts 1949, No. 302, § 2; 1959, No. 186, § 2; 1979, No. 198, § 1; A.S.A. 1947, § 82-103; Acts 2005, No. 1954, § 5; 2007, No. 384, § 4; 2013, No. 435, § 1; 2019, No. 910, § 4924.

Amendments. The 2013 amendment deleted the former last sentence in (a) and added (b).

The 2019 amendment redesignated former (b)(2) as (b)(2)(A); added (b)(2)(B) and (b)(2)(C); substituted “may” for “shall” in the introductory language of (b)(3); substituted “but shall not sit as a member of the State Board of Health” for “and shall have all the powers of a member of the State Board of Health” in (b)(3)(B); and substituted “Secretary of the Department of Health” for “State Board of Health” three times in (b)(3)(C).

20-7-104. Members — Compensation.

All appointed members of the State Board of Health may receive expense reimbursement and stipends in accordance with § 25-16-901 et seq.

History. Acts 1913, No. 96, § 27; C. & M. Dig., § 5142; Pope's Dig., § 6413; Acts 1955, No. 82, § 1; 1975, No. 383, § 1; A.S.A. 1947, § 82-105; Acts 1997, No. 250, § 178; 2005, No. 1954, § 5.

20-7-105. Proceedings.

1. 1. The State Board of Health shall meet at least one (1) time every three (3) months.
   2. Upon the call of the President of the State Board of Health or a majority of the members of the board, the board shall meet at such other times as may be necessary in the interest of public health.
2. 1. The board may adopt bylaws regulating the transaction of its business and provide within the bylaws for the appointment of committees to which the board may delegate authority and power for all duties committed to the board, but under the direction and subject to the control of the board.
   2. The board may also adopt and use an official seal.
3. A majority of the members of the board shall constitute a quorum for the transaction of business and for the performance of such duties as the board may prescribe.

History. Acts 1913, No. 96, §§ 3, 4; C. & M. Dig., §§ 5127, 5128; Acts 1929, No. 109, § 2; Pope's Dig., §§ 6390, 6399; A.S.A. 1947, §§ 82-107, 82-108; Acts 2005, No. 1954, § 5; 2007, No. 384, § 5.

20-7-106. Office.

The office of the State Board of Health shall be located in Little Rock, and the board shall be furnished with all necessary equipment and supplies, including laboratory supplies, books, stationery, blanks, furniture, etc., as are provided other officers of the state and as are necessary for carrying on the work of the board, and the office is to be provided in a suitable building to be designated by the Secretary of the Department of Health.

History. Acts 1913, No. 96, § 24; C. & M. Dig., § 5139; Pope's Dig., § 6410; A.S.A. 1947, § 82-102; Acts 2005, No. 1954, § 5; 2007, No. 384, § 6; 2019, No. 910, § 4925.

Amendments. The 2019 amendment substituted “Secretary of the Department of Health” for “Director of the Department of Health”.

20-7-107. Appointment of assistant director.

The Secretary of the Department of Health may appoint and employ an assistant director who shall be knowledgeable in the field of public health and whose duty it shall be to assist the secretary in the general supervision of the affairs of his or her office and in the enforcement of quarantine and sanitation throughout the state.

History. Acts 1953, No. 282, § 1; 1979, No. 797, § 1; A.S.A. 1947, § 82-104; Acts 2019, No. 910, § 4926.

Amendments. The 2019 amendment substituted “Secretary of the Department of Health” for “Director of the Department of Health”.

20-7-108. Engagement of certain personnel.

The Department of Health may engage suitable persons to render sanitary service, to make or supervise practical and scientific investigations and examinations requiring expert skill, and to prepare plans and to report relative to sanitary service.

History. Acts 1881, No. 85, § 10, p. 177; C. & M. Dig., § 5132; Pope's Dig., § 6403; A.S.A. 1947, § 82-114; Acts 2019, No. 910, § 4927.

Amendments. The 2019 amendment substituted “The Department of Health” for “From time to time, the State Board of Health”.

20-7-109. Authority to regulate public health — Exceptions.

1. 1. Power is conferred on the State Board of Health to make all necessary and reasonable rules of a general nature for:
      1. The protection of the public health and safety;
      2. The general amelioration of the sanitary and hygienic conditions within the state;
      3. The suppression and prevention of infectious, contagious, and communicable diseases;
      4. The proper enforcement of quarantine, isolation, and control of such diseases; and
      5. The proper control of chemical exposures that may result in adverse health effects to the public.
   2. All rules promulgated pursuant to this subsection shall be reviewed by the House Committee on Public Health, Welfare, and Labor and the Senate Committee on Public Health, Welfare, and Labor or appropriate subcommittees thereof.
2. However, if a patient can be treated with reasonable safety to the public health, he or she shall not be removed from his or her home without his or her consent, or the consent of the parents or guardian in the case of a minor, and the rules, when made, shall be printed in pamphlet form, with such numbers of copies as may be necessary for the distribution of the information to health bodies, health and sanitary officers, and the public generally.
3. The board shall not regulate the practice of medicine or healing nor interfere with the right of any citizen to employ the practitioner of his or her choice.

History. Acts 1913, No. 96, § 6; C. & M. Dig., § 5130; Pope's Dig., § 6401; A.S.A. 1947, § 82-110; Acts 1991, No. 990, §§ 3, 5; 1997, No. 179, § 20; 2019, No. 315, § 1803.

Amendments. The 2019 amendment deleted “and regulations” following “rules” throughout the section.

Cross References. Adoption of rules and regulations for abortion clinics by Department of Health, § 20-9-302.

20-7-110. Study and prevention of diseases.

1. 1. The State Board of Health has general supervision and control of all matters pertaining to the health of the citizens of this state.
   2. The board shall make a study of the causes and prevention of infectious, contagious, and communicable diseases, and, except as otherwise provided in this act, the board shall have direction and control of all matters of quarantine rules and enforcement. The board shall have full power and authority to prevent the entrance of such diseases from points outside the state.
   3. The board shall also have direction and control over all sanitary and quarantine measures for dealing with all infectious, contagious, and communicable diseases within the state and direction and control to suppress them and prevent their spread.
2. Whenever the health of the citizens of this state is threatened by the prevalence of any epidemic or contagious disease in this or any adjoining state and, in the judgment of the Governor, the public safety demands action on the part of the board, then the Governor shall call the attention of the board to the facts and order it to take such action as the public safety of the citizens demands to prevent the spread of the epidemic or contagious disease.

History. Acts 1895, No. 152, § 1, p. 236; 1913, No. 96, § 5; C. & M. Dig., §§ 5129, 5135; Pope's Dig., §§ 6400, 6406; A.S.A. 1947, §§ 82-109, 82-115; Acts 2019, No. 315, § 1804.

Amendments. The 2019 amendment substituted “rules” for “regulations” in (a)(2).

Meaning of “this act”. See note to § 20-7-101.

20-7-111. Administration of certain federal acts.

1. The State of Arkansas does accept the benefits of any acts now passed or hereafter to be passed by the United States Congress to provide for cooperation with the states in the protection of mothers and infants and promotion of a public health program.
2. 1. The State Board of Health is designated as the board for the purpose of carrying into effect the provisions of the federal acts and this section and shall have all necessary authority to cooperate with the federal authorities administering the acts of the United States Congress.
   2. The board shall administer any legislation pursuant thereto enacted by the State of Arkansas under this section for promotion of a health program.
3. 1. The Secretary of the Department of Health shall act as executive officer for the purpose of administering the federal acts and this section.
   2. The secretary shall carry into effect such rules and regulations as the federal authorities and the board may adopt pursuant to the federal acts and this section.
4. The Treasurer of State is designated and appointed custodian of all moneys received by the state from the appropriation made by the United States Congress, and he or she may receive and provide for the proper custody of the moneys and make disbursements in the manner provided by law and for the purpose specified in this section.
5. The allocation of funds under this section shall be made to the respective counties in consecutive order as they make application and qualify for the funds.
6. 1. Any person, firm, or corporation violating any of the provisions of this section upon conviction shall be guilty of a violation and shall be fined not more than five hundred dollars ($500) at the discretion of the court.
   2. Each day that the violation is committed shall constitute a separate offense.

History. Acts 1931, No. 235, §§ 3-6, 10, 11; Pope's Dig., §§ 6392-6395, 6397, 6398; A.S.A. 1947, §§ 82-123 — 82-128; Acts 2005, No. 1994, § 103; 2019, No. 910, § 4928.

Amendments. The 2019 amendment substituted “Secretary of the Department of Health” for “Director of the Department of Health” in (c)(1) and substituted “secretary” for “director” in (c)(2).

20-7-112. Inspections.

1. It is made the duty of all officers and agents who have the control, charge, or custody of any public structure, work, grounds, or erection, or of any plan, description, outlines, drawings, or charts thereof or relating thereto, made, kept, or controlled under any public authority, to permit and facilitate the examination and inspection and the making of copies of these items by any officer or person authorized by the State Board of Health.
2. The members of the board and such other officers or persons as may at any time be authorized by the board, without fee or hindrance, to enter, examine, and survey all grounds, erections, vehicles, structures, apartments, buildings, and plans when the public health may be promoted or in any way preserved.

History. Acts 1881, No. 85, § 10, p. 177; C. & M. Dig., § 5132; Pope's Dig., § 6403; A.S.A. 1947, § 82-114.

20-7-113. Nuisances.

1. 1. At any time, the Governor may require the State Board of Health to examine nuisances or questions affecting the security of life and health in any locality in the state, and in such cases the State Board of Health shall have all the necessary powers to make those examinations. The State Board of Health shall report the results to the Governor within the limits of time which he or she shall prescribe for the examination and report to be prepared and submitted.
   2. At any time, whether an investigation is at the request of the State Board of Health, or whenever the Governor shall have directed an examination and report to be made by the State Board of Health into any alleged nuisance, any board of health of any city of the state may appoint and select any one (1) of its officers as its representative during the examination of any nuisance. This representative officer shall have a seat at and be entitled to take part in all the deliberations of the State Board of Health during the investigation but without the right to vote.
2. When approved by the Governor, the report of the examination shall be filed in the office of the Secretary of State, and the Governor, in relation to the matters or things found and certified by the State Board of Health to be a nuisance, may declare them to be public nuisances and order them to be changed as he or she shall direct, or be abated and removed.
3. Any violation of an order shall be held and punished as a misdemeanor, and thereafter the Governor, by his or her order in writing which is certified under his or her official seal and directed to the officers of the county in which the nuisance shall be situated, may require the prosecuting attorney, the sheriff, and the other officers of every county to take all necessary measures to execute the order of the Governor and to have it obeyed.

History. Acts 1881, No. 85, §§ 8, 9, p. 177; C. & M. Dig., §§ 5133, 5134; Pope's Dig., §§ 6404, 6405; A.S.A. 1947, §§ 82-112, 82-113.

20-7-114. Public health laboratory.

1. 1. The State Board of Health shall establish, equip, and maintain a public health laboratory that shall be used for making:
      1. Analyses of foods and drugs to enforce pure food and drug laws;
      2. Analyses of the environment to investigate cases or suspected cases of human exposure; and
      3. Investigations of cases and suspected cases of malaria, diphtheria, typhoid fever, tuberculosis, epidemic cerebrospinal meningitis, glanders, hookworm disease, rabies, and other infectious, contagious, communicable, and debilitating diseases.
   2. The public health laboratory shall be established and maintained at the Department of Health under the direct supervision of the Secretary of the Department of Health or his or her authorized representatives.
2. 1. The department may establish fees to be charged for performing analyses of various types of samples submitted to the public health laboratory for examination.
   2. All fees levied and collected under this subsection are special revenues and shall be deposited into the State Treasury, there to be credited to the Public Health Fund.
3. Subject to rules as may be implemented by the Chief Fiscal Officer of the State, the disbursing officer for the department may transfer all unexpended funds relative to the laboratory services that pertain to fees collected, as certified by the Chief Fiscal Officer of the State, to be carried forward and made available for expenditures for the same purpose for any following fiscal year.

History. Acts 1913, No. 96, § 21; C. & M. Dig., § 5136; Pope's Dig., § 6407; A.S.A. 1947, § 82-118; Acts 1987, No. 146, § 1; 1991, No. 990, §§ 4, 5; 1993, No. 485, § 1; 1997, No. 179, § 21; 2013, No. 564, § 2; 2019, No. 315, § 1805; 2019, No. 910, § 4929.

Amendments. The 2013 amendment substituted “Department of Health” for “Division of Health of the Department of Health and Human Services” twice in (a)(2); deleted the (b)(1)(A) designation and deleted (b)(1)(B); substituted “department” for “division” in (b)(1) and (c); and deleted former (b)(3) and (d).

The 2019 amendment by No. 315 deleted “and regulations” following “rules” in (c).

The 2019 amendment by No. 910 substituted “Secretary of the Department of Health” for “Director of the Department of Health” in (a)(2).

20-7-115. Transportation of dead bodies.

1. 1. The State Board of Health shall prepare the necessary methods and forms and prescribe the rules regulating the issue and use of transfer permits, with the proper coupons attached thereto, to be issued by local organized boards of health or health officers, for the transportation of the dead bodies of persons which are to be transported for burial beyond the limits of the counties where the death occurred.
   2. In all cases, the State Board of Health shall require the coupons to be attached to the permits, to be detached and preserved by every common carrier or the person in charge of any vessel, railroad train, or vehicle to whom the dead bodies shall be delivered for transportation.
2. Any violation of these rules shall be a misdemeanor.

History. Acts 1881, No. 85, § 7, p. 177; C. & M. Dig., § 5131; Pope's Dig., § 6402; A.S.A. 1947, § 82-111; Acts 2019, No. 315, § 1806.

Amendments. The 2019 amendment deleted “and regulations” following “rules” in (b).

20-7-116. [Repealed.]

Publisher's Notes. This section, concerning perinatal health, was repealed by Acts 2009, No. 952, § 1. The section was derived from Acts 1979, No. 159, §§ 1-5; 1979, No. 723, § 3; A.S.A. 1947, §§ 5-911.1 — 5-911.5.

20-7-117. Hospices — Definition — State Hospice Office — Creation.

1. There is created within the Department of Health a State Hospice Office to be administered in a division of the department to be designated by the Secretary of the Department of Health.
2. 1. The office shall:
      1. Coordinate the care of terminally ill persons with all existing agencies, programs, and facilities;
      2. Implement rules, regulations, and standards for hospice care in general agreement with guidelines of the National Hospice and Palliative Care Organization and the Hospice and Palliative Care Association of Arkansas, Inc. and in compliance with the Centers for Medicare & Medicaid Services;
      3. Provide technical assistance and information to developing hospices;
      4. Maintain a central storehouse of information and reference materials relating to the hospice concept and disseminate this to programs and individuals on request in an equitable manner and accept and respond to inquiries relating to hospice; and
      5. Assist the Arkansas State Hospice Association in developing the hospice concept in this state and networking hospice programs with existing medical communities and human service facilities.
   2. All functions and duties of the office shall be carried out in accordance with the laws of Arkansas and the rules of the Health Services Permit Agency, the Health Services Permit Commission, and the Centers for Medicare & Medicaid Services.
3. 1. The rules and requirements of the Health Services Permit Agency and the commission shall be revised to include separate permit-of-approval categories of healthcare facilities entitled “hospice facilities” and “hospice agencies” and to develop criteria for granting the permits of approval for hospice facilities and for hospice agencies for which applications shall be filed in accordance with the criteria.
   2. A hospice facility or hospice agency shall not convert its licensure to any other license.
4. As used in this section, “hospice” or “hospice program” means an autonomous, centrally administered, medically directed, coordinated program providing a continuum of home, outpatient, and homelike inpatient care for the terminally ill patient and the patient's family, and which employs an interdisciplinary team to assist in providing palliative and supportive care to meet the special needs arising out of the physical, emotional, spiritual, social, and economic stresses which are experienced during the final stages of illness and during dying and bereavement. The care shall be available twenty-four (24) hours a day, seven (7) days a week, and provided on the basis of need, regardless of ability to pay.
5. The licensure fee for a hospice shall be an annual fee of five hundred dollars ($500).

History. Acts 1983, No. 283, §§ 1-4; A.S.A. 1947, §§ 5-911.6 — 5-911.9; Acts 1997, No. 396, §§ 1, 2; 1997, No. 574, § 3; 2001, No. 1800, §§ 4, 5; 2007, No. 827, § 146; 2019, No. 315, §§ 1807, 1808; 2019, No. 910, § 4930.

Amendments. The 2019 amendment by No. 315 substituted “rules” for “regulations” in (b)(2) and (c)(1).

The 2019 amendment by No. 910 substituted “Secretary of the Department of Health” for “Director of the Department of Health” in (a).

Cross References. Rights of the terminally ill, § 20-17-201 et seq.

Health Facility Services Revolving Fund, § 19-5-1089.

20-7-118. Annual conference for health officers.

1. There shall be an annual conference of county health officers and city health officers of this state, meeting at such time and place as the State Board of Health designates. The President of the State Board of Health or some member of the board shall preside at the conference.
2. Each of the several counties, towns, and cities may provide for and pay the necessary expenses of its county health officer or city health officer for attendance at the conference.

History. Acts 1913, No. 96, § 31; C. & M. Dig., § 5145; Pope's Dig., § 6416; A.S.A. 1947, § 82-120.

20-7-119. Identification tags and bracelets.

1. When application is made and upon the payment of the fees provided in this section, the Department of Health may prepare and furnish to the applicant either a suitable metal tag commonly referred to as “dog tag” or an identification bracelet which may be inscribed with, in addition to the name and address of the person, the birth date, blood type, and any other pertinent medical information that might be needed in case of an accident or emergency with respect to the person.
2. The department shall charge a fee of fifty cents (50¢) for each metal tag or dog tag and a fee of one dollar ($1.00) for each identification bracelet containing the information authorized in this section.
3. All fees collected under this section shall be deposited into the State Treasury as special revenues, and the Treasurer of State shall credit them, after deducting from them the collection charge authorized by law, to the Public Health Fund to be used to defray the cost of this section and for the maintenance and operation of the department.

History. Acts 1965, No. 433, §§ 1, 2; A.S.A. 1947, §§ 82-131, 82-132.

20-7-120. No right to enter home or take charge of children.

1. No official, agent, or representative of the Department of Health shall have any right under this section to enter any home over the objection of the owner of the home or to take charge of any child over the objection of either or both parents or of the person standing in loco parentis or having custody of the child.
2. Nothing in this section shall be construed as limiting the power of a parent or guardian or person standing in loco parentis to determine what treatment or correction shall be provided for a child or the agencies to be employed for these purposes.

History. Acts 1923, No. 92, § 5; Pope's Dig., § 6453; A.S.A. 1947, § 82-129.

20-7-121. Annual report.

1. It shall be the duty of the State Board of Health to make an annual written report through the Secretary of the Department of Health to the Governor on or before January 1 of each year.
2. The report shall include:
   1. A financial statement covering the expenditures of all funds appropriated for the board's purposes;
   2. So much of the proceedings of the board and information concerning vital and mortuary statistics, knowledge respecting diseases, and instructions on the subject of sanitation and hygiene which may be thought useful by the board for dissemination among the people; and
   3. Such suggestions as to legislative action as the board deems necessary.

History. Acts 1913, No. 96, § 29; C. & M. Dig., § 5143; Pope's Dig., § 6414; A.S.A. 1947, § 82-122; Acts 2019, No. 910, § 4931.

Amendments. The 2019 amendment substituted “Secretary of the Department of Health” for “Director of the Department of Health” in (a).

20-7-122. Reports for general distribution.

The State Board of Health may publish for general distribution such reports and other matter as it may deem useful in promoting the interest of the public health of this state.

History. Acts 1913, No. 96, § 23; C. & M. Dig., § 5138; Pope's Dig., § 6409; A.S.A. 1947, § 82-119.

20-7-123. Fees.

1. All revenue derived from fees collected pursuant to this section shall be deposited as special revenues into the State Treasury, where they shall be credited to the Public Health Fund.
2. These fees are as follows:
   1. All fees prescribed in the Vital Statistics Act, § 20-18-101 et seq., which are as follows:
      1. A fee of fifteen dollars ($15.00) collected by the State Registrar of Vital Records for the filing of a delayed certificate of birth;
      2. A fee of fifteen dollars ($15.00) collected by the state registrar for the filing of a delayed certificate of death or marriage;
      3. A fee of fifteen dollars ($15.00) collected by the state registrar for issuing a new certificate of birth for a person who has been legitimated, or whose paternity has been determined, or whose name has been changed;
      4. 1. A fee of one dollar ($1.00) collected by the clerks of the county courts upon the application of any person for marriage.
         2. This fee is in addition to any other fees;
      5. 1. Except as provided in subdivision (b)(1)(E)(ii) of this section, a fee of fifteen dollars ($15.00) collected by the state registrar for the amendment of any record.
         2. For a hospital that requests an amendment of a record, a fee of two dollars ($2.00);
      6. A fee of five dollars ($5.00) collected by the state registrar for the making and certification of any certificate or record other than a death certificate;
      7. A fee of:
         1. Four dollars ($4.00) collected by the state registrar for the making and certification of a single copy of a death certificate; and
         2. One dollar ($1.00) collected for the making and certification of each additional copy of a death certificate;
      8. 1. A fee of:
            1. Five dollars ($5.00) collected by the state registrar for an examination and search of the files for any birth, marriage, divorce, or putative father record; and
            2. Four dollars ($4.00) for an examination and search of the files for a death record.
         2. The fees set out in this subdivision (b)(1)(H) shall be paid before searching the record; and
      9. A fee of five dollars ($5.00) collected by the state registrar for establishing a new certificate of birth under § 20-18-406;
   2. 1. A fee to be collected for the review of plans and specifications covering improvements that by law or rule are required to be reviewed by the State Board of Health or Department of Health, including without limitation plans and specifications covering waterworks, sewage works, swimming pools, hospitals and related facilities, food service and food processing establishments, and plumbing in public facilities.
      2. The fee imposed under subdivision (b)(2)(A) of this section shall be one percent (1%) of the estimated cost, with a maximum fee of five hundred dollars ($500) and a minimum fee of fifty dollars ($50.00), calculated and paid on the basis of the engineering estimate of the total cost of the particular improvement, which estimate is to be submitted with the plans and specifications for review.
      3. If the maximum fee of five hundred dollars ($500) is paid, no engineering estimate of the total cost need be submitted with the plans and specifications; and
   3. A fee of fifty dollars ($50.00) to be collected by the board or the department for each cemetery inspection as required by law or rule.

History. Acts 1965, No. 469, § 10; 1983, No. 378, § 2; 1985, No. 351, §§ 1, 4; A.S.A. 1947, §§ 82-130, 82-130.1; Acts 1987, No. 399, §§ 1, 2; 1993, No. 350, § 6; 1993, No. 403, § 11; 1995, No. 270, § 14; 1995, No. 1254, § 29; 1995, No. 1256, § 20; 1995 (1st Ex. Sess.), No. 13, § 4; 2001, No. 957, §§ 1-4; 2003, No. 1723, § 14; 2007, No. 827, § 147; 2007, No. 1059, § 1; 2019, No. 315, §§ 1809, 1810.

A.C.R.C. Notes. The operation of subdivision (b)(1) may be affected by the enactment of Act 1256 of 1995, codified principally at § 16-10-301 et seq.

Pursuant to Acts 2007, No. 827, § 240, the amendment of § 20-7-123 by Acts 2007, No. 1059, § 1 supersedes the amendment of § 20-7-123 by Acts 2007, No. 827, § 147.

Publisher's Notes. Acts 1985, No. 351, § 5 provided that it was the purpose and intent of Acts 1985, No. 351 to levy increased or additional fees to be collected by the Division of Vital Records with part of the additional fees to be credited to the Public Health Fund. It was not the intent of that Act to in any way jeopardize revenues pledged to secure bonds issued under the provisions of Acts 1965, No. 469 or to otherwise impair the obligations on such bonds.

Acts 1985, No. 351, § 4, is also codified as § 20-18-306.

Amendments. The 2019 amendment substituted “rule” for “regulation” in (b)(2)(A) and (b)(3).

Cross References. Circuit court clerks fees, § 21-6-402 et seq.

Marriage license fee, § 14-20-111.

Amount of fees levied by this section going to the Health Department Technology Fund, § 19-6-485.

20-7-124. Disposition of certain fees.

All fees collected by the Department of Health for food-related establishment permits, septic tank permits, and milk permits shall be deposited into the State Treasury to the credit of the Public Health Fund and shall be for the use of the Division of Environmental Health Protection of the Department of Health.

History. Acts 1977, No. 889, § 36.

Cross References. Food services establishments, § 20-57-201 et seq.

Milk products, § 20-59-101 et seq.

20-7-125. Payment of certain salaries and expenses.

All salaries and other expenses provided for by this act which are not required to be paid by counties, cities, and incorporated towns shall be paid out of the Public Health Fund.

History. Acts 1913, No. 96, § 30; C. & M. Dig., § 5144; Pope's Dig., § 6415; A.S.A. 1947, § 82-106.

Meaning of “this act”. See note to § 20-7-101.

20-7-126. Payment of overtime for home health employees.

1. The Department of Health may make overtime payments to employees engaged in the performance of home health activities.
2. The payments are to be in addition to compensation otherwise due the employees at the same rate currently paid to the employees for regular time, but on an hourly basis.

History. Acts 1989 (1st Ex. Sess.), No. 991, § 33.

A.C.R.C. Notes. Former § 20-7-126, concerning payment of overtime for home health employees, is deemed to be superseded by this section. The former section was derived from Acts 1985, No. 718, § 25.

20-7-127. [Repealed.]

Publisher's Notes. This section, concerning fees for visits to local health units, was repealed by Acts 2017, No. 206, § 1. The section was derived from Acts 1987, No. 677, §§ 1-3; 1993, No. 350, §§ 4, 5.

20-7-128. Maintenance fee for breath-testing instruments.

1. 1. The State Board of Health may assess a fee for the maintenance of breath-testing instruments by law enforcement agencies for purposes contained in the Omnibus DWI or BWI Act, § 5-65-101 et seq., and § 5-65-201 et seq.
   2. The fees collected shall be used for the support of the maintenance program as appropriated by law.
   3. This subsection does not exclude manufacturer-approved repair services.
2. The fee imposed shall not exceed the cost of maintenance by the Department of Health.
3. 1. Funds derived from the fees levied under this section are special revenues and shall be collected by the department and deposited into the State Treasury, where they shall be credited to the Public Health Fund.
   2. Subject to such rules as may be implemented by the Chief Fiscal Officer of the State, the disbursing officers for the department may transfer all unexpended funds relative to the blood alcohol instrument maintenance program funds outlined in this section, as certified by the Chief Fiscal Officer of the State, to be carried forward and made available for the expenditures for the same purpose for any following year.

History. Acts 1989, No. 577, § 1; 2019, No. 315, § 1811.

Amendments. The 2019 amendment deleted “and regulations” following “rules” in (c)(2).

20-7-129. Reimbursement for certain medical supplies or services.

1. 1. The Department of Health may implement a reimbursement system to recover part or all of the costs of delivering services.
   2. For the purpose of vaccine and vaccine administration reimbursement, if a private healthcare insurer declines or does not respond to a request to contract with the department within ninety (90) days of the request to contract, the private healthcare insurer shall reimburse the department at the rate paid to an in-network provider.
2. The system shall provide that fees shall be collected only from those patients who are financially able to pay the fee and that no one shall be denied services because of inability to pay.
3. 1. Funds derived from the fees shall be used exclusively for the purchase of medical supplies or services necessary to enable the department to continue to provide essential health care.
   2. The department may transfer six hundred thousand dollars ($600,000) in any fiscal year to the State Health Department Building and Local Grant Trust Fund for the purposes established by § 20-7-204.
4. 1. Funds collected by the department under this section shall be deposited into the State Treasury. These funds shall be credited to the Public Health Fund to be used exclusively for support of medical supplies or services.
   2. Subject to rules as may be implemented by the Chief Fiscal Officer of the State, all unexpended funds that pertain to fees collected shall be carried forward and made available for expenditure for the same purposes for any following fiscal year.

History. Acts 1989, No. 387, §§ 1, 2; 2013, No. 564, § 1; 2015, No. 1052, § 1; 2017, No. 206, § 2; 2019, No. 315, § 1812.

Amendments. The 2013 amendment, in (a), substituted “Department of Health” for “State Board of Health may adopt rules and regulations to” and “delivering” for “certain medical supplies or”; substituted “Department of Health” for “Division of Health of the Department of Health and Human Services” in (c); deleted former (d) and (e) and redesignated former (f) as present (d).

The 2015 amendment added designation (a)(1); and added (a)(2).

The 2017 amendment added the designation (c)(1); and added (c)(2).

The 2019 amendment deleted “and regulations” following “rules” in (d)(2).

20-7-130. Recovery of expenditures for extraordinary operations.

1. The purpose of this section is to more equitably allocate the costs between the state and responsible parties when unforeseen circumstances arise as a result of accidents and other man-made causes which require assistance from the Department of Health. The authority to recover these expenses would enable the department to replace funds budgeted for routine activities which were spent for a department response to nonroutine, unplanned circumstances creating the potential for adverse health effects such as transportation accidents involving food and drugs, environmental contamination, and food product contamination.
2. 1. The State Board of Health may promulgate rules necessary to carry out the intent and purpose of this section.
   2. In adopting these rules, the board shall define the circumstances under which recovery should be pursued and the method to determine the amount of each recovery, which shall be based on costs.
3. The department may recover from the responsible party or parties actual costs incurred in participation during extraordinary, time-consuming operations such as damage assessment, sampling, monitoring, health studies, and product evaluations which arise from unforeseen circumstances.
4. All moneys levied and collected under this section are special revenues and shall be deposited into the State Treasury, there to be credited to the Public Health Fund.
5. Subject to rules as may be implemented by the Chief Fiscal Officer of the State, the disbursing officer for the department may transfer all unexpended funds relative to the recovery of expenditures program that pertain to moneys collected, as certified by the Chief Fiscal Officer of the State, to be carried forward and made available for expenditures for the same purpose for any following fiscal year.

History. Acts 1989, No. 384, §§ 1, 2; 2019, No. 315, §§ 1813, 1814.

Amendments. The 2019 amendment deleted “and regulations” following “rules” in (b)(2) and (e).

20-7-131. Local control of county or city units of Department of Health.

1. The mayor or county judge of any city or county that is providing facilities for a local unit of the Department of Health shall be consulted before the hiring of or the removal of the administrator of the local unit.
2. Notwithstanding the Freedom of Information Act of 1967, § 25-19-101 et seq., the department with the consent of the employee may share personnel information with a mayor or county judge.
3. Furthermore, any employee removed as administrator of a local unit shall be allowed to participate in the state grievance process.

History. Acts 2003, No. 657, § 1.

20-7-132. Guidelines for cleanup of clandestine methamphetamine labs.

1. The Department of Health shall develop guidelines for the cleanup of former clandestine methamphetamine drug labs.
2. The guidelines shall be made available on the department's website and shall be available to law enforcement officials and the public upon request.
3. The guidelines shall be reviewed and updated annually.

History. Acts 2003, No. 1270, § 1.

Publisher's Notes. As enacted by Acts 2003, No. 1270, subsection (a) ended: “by April 1, 2004.”

20-7-133. Child Health Advisory Committee — Creation.

1. There is created a Child Health Advisory Committee to consist of twenty (20) members.
2. 1. The Secretary of the Department of Health shall appoint:
      1. One (1) member to represent the Department of Health;
      2. One (1) member to represent the Arkansas Academy of Nutrition and Dietetics;
      3. One (1) member to represent the American Academy of Pediatrics, Arkansas Chapter;
      4. One (1) member to represent the Arkansas Academy of Family Physicians;
      5. One (1) member to represent the Arkansas Association for Health, Physical Education, Recreation and Dance;
      6. One (1) member to represent jointly the American Heart Association, the American Cancer Society, and the American Lung Association;
      7. One (1) member to represent the Fay W. Boozman College of Public Health of the University of Arkansas for Medical Sciences;
      8. One (1) member to represent the Arkansas Center for Health Improvement;
      9. One (1) member to represent the Arkansas Advocates for Children and Families;
      10. One (1) member to represent the University of Arkansas Cooperative Extension Service; and
      11. One (1) member to represent the Office of Minority Health and Health Disparities of the Department of Health.
   2. The Commissioner of Elementary and Secondary Education shall appoint:
      1. One (1) member to represent the Division of Elementary and Secondary Education;
      2. One (1) member to represent the Arkansas School Nutrition Association;
      3. One (1) member to represent the Arkansas School Nurses Association;
      4. One (1) member to represent the Arkansas Association of Educational Administrators;
      5. One (1) member to represent the Arkansas Parent Teacher Association;
      6. One (1) member to represent the Arkansas School Boards Association;
      7. One (1) member to represent the Arkansas Association of School Business Officials;
      8. One (1) member to represent the Arkansas Association for Supervision and Curriculum Development; and
      9. One (1) member who is a classroom teacher.
3. Terms of committee members shall be three (3) years except for the initial members, whose terms shall be determined by lot so as to stagger terms to equalize as nearly as possible the number of members to be appointed each year.
4. If a vacancy occurs, the officer who made the original appointment shall appoint a person who represents the same constituency as the member being replaced.
5. The committee shall elect one (1) of its members to act as chair for a term of one (1) year.
6. A majority of the members shall constitute a quorum for the transaction of business.
7. The committee shall meet at least monthly.
8. The Department of Health shall provide office space and staff for the committee.
9. Members of the committee shall serve without pay but may receive expense reimbursement in accordance with § 25-16-902 if funds are available.

History. Acts 2003, No. 1220, § 1; 2007, No. 719, § 1; 2019, No. 910, §§ 4932-4934.

Amendments. The 2019 amendment substituted “Secretary of the Department of Health” for “Director of the Department of Health” in the introductory language of (b)(1); substituted “Commissioner of Elementary and Secondary Education” for “Commissioner of Education” in the introductory language of (b)(2); and substituted “Division of Elementary and Secondary Education” for “Department of Education” in (b)(2)(A).

20-7-134. Powers and duties.

1. The Child Health Advisory Committee shall meet at least one (1) time per month and make recommendations to the State Board of Education and the State Board of Health consistent with the intent and purpose of this section and §§ 20-7-133 and 20-7-135.
2. The committee shall develop nutrition and physical activity standards and policy recommendations with consideration of the following:
   1. Foods sold individually in school cafeterias but outside the regulated National School Lunch Program;
   2. Competitive foods as defined by the United States Department of Agriculture as the definition is in existence on January 1, 2015, and offered at schools typically through vending machines, student stores, school fundraisers, food carts, or food concessions;
   3. The continuing professional development of food service staff;
   4. The expenditure of funds derived from competitive food and beverage contracts;
   5. Physical education and activity;
   6. Systems to ensure the implementation of nutrition and physical activity standards; and
   7. The monitoring and evaluating of results and reporting of outcomes.
3. The committee shall examine the progress of the Arkansas Coordinated School Health Program and make recommendations to the Division of Elementary and Secondary Education and the Department of Health concerning the implementation of the Arkansas Coordinated School Health Program.

History. Acts 2003, No. 1220, § 1; 2007, No. 719, § 1; 2015, No. 846, § 36; 2019, No. 910, § 2278.

Amendments. The 2015 amendment substituted “January 1, 2015” for “January 1, 2003” in (b)(2).

The 2019 amendment substituted “Division of Elementary and Secondary Education” for “Department of Education” in (c).

20-7-135. Nutrition and physical activity standards — Implementation.

1. After having consulted the Child Health Advisory Committee and the State Board of Health, the State Board of Education shall promulgate appropriate rules to ensure that nutrition and physical activity standards and body mass index for age assessment protocols are implemented to provide students with the skills, opportunities, and encouragement to adopt healthy lifestyles.
2. The Department of Health in consultation with the Division of Elementary and Secondary Education shall:
   1. Employ one (1) qualified community health promotion professional with training or experience, or both, in nutrition, chronic disease, or another related field to be housed within the department to plan, develop, implement, and evaluate pilot or model programs to support schools and communities if funds are available;
   2. Employ one (1) statewide health promotion consultant to be housed within the division if funds are available;
   3. Employ one (1) person as a community health promotion specialist to support implementation of pilot or model programs in schools and communities in nutrition and physical activity in several distinct geographical areas of the state if funds are available;
   4. Assign all community health nurses under its supervision to work with schools to assure that body mass index for age assessment protocols are followed by school employees or their designees who conduct body mass index for age assessments and other student health screenings; and
   5. Not use more than five percent (5%) of the annual Department of Health Master Settlement Agreement funds for the salaries or programs created under this subsection.
3. Every school district shall:
   1. Prohibit for elementary school students in-school access to vending machines offering food and beverages;
   2. Require schools to include as part of the annual report to parents and the community the amounts and specific sources of funds received and expenditures made from competitive food and beverage contracts;
   3. Beginning with kindergarten and then in even-numbered grades, require schools to include as a part of a student health report to parents a body mass index percentile by age for each student; and
   4. 1. Permit any parent to refuse to have his or her child's body mass index percentile for age assessed and reported, by providing a written refusal to the school.
      2. Students in grades eleven (11) and twelve (12) are exempt from any policy or requirement of a public school or the state for measuring or reporting body mass index.
4. The division shall:
   1. Begin the implementation of standards developed by the Child Health Advisory Committee and approved by the division; and
   2. Annually monitor and evaluate the implementation and effectiveness of the nutrition and physical education standards.
5. Every school district shall:
   1. Convene a school nutrition and physical activity advisory committee that shall include members from school district governing boards, school administrators, food service personnel, teacher organizations, parents, students, and professional groups such as nurses and community members to:
      1. Help raise awareness of the importance of nutrition and physical activity; and
      2. Assist in the development of local policies that address issues and goals, including but not limited to the following:
         1. Assisting with the implementation of nutrition and physical activity standards developed by the school nutrition and physical activity advisory committee with the approval of the division and the State Board of Health;
         2. Integrating nutrition and physical activity into the overall curriculum;
         3. Ensuring that professional development for staff includes nutrition and physical activity issues;
         4. Ensuring that students receive nutrition education and engage in healthful levels of vigorous physical activity;
         5. Improving the quality of physical education curricula and increasing training of physical education teachers;
         6. Enforcing existing physical education requirements; and
         7. Pursuing contracts that both encourage healthy eating by students and reduce school dependence on profits from the sale of foods of minimal nutritional value;
   2. Begin the implementation of standards developed by the Child Health Advisory Committee with the approval of the division and the State Board of Health; and
   3. Require that goals and objectives for nutrition and physical activity be incorporated into the annual school planning and reporting process.
6. 1. The division and the department shall report annually on progress in implementing nutrition and physical education standards to the:
      1. Chair of the House Committee on Public Health, Welfare, and Labor;
      2. Chair of the Senate Committee on Public Health, Welfare, and Labor;
      3. Chair of the House Committee on Education; and
      4. Chair of the Senate Committee on Education.
   2. The State Board of Education shall submit to the House Committee on Education and the Senate Committee on Education for the House Committee on Education's and the Senate Committee on Education's review any proposed rules regarding physical education or physical activity standards for grades kindergarten through twelve (K-12) developed pursuant to this section.

History. Acts 2003, No. 1220, § 1; 2003 (2nd Ex. Sess.), No. 29, § 1; 2007, No. 201, § 1; 2007, No. 317, § 3; 2019, No. 315, § 1815; 2019, No. 910, §§ 2279-2285.

Amendments. The 2019 amendment by No. 315 deleted “and regulations” following “rules” in (a).

The 2019 amendment by No. 910 substituted “Division of Elementary and Secondary Education” for “Department of Education” throughout the section; and substituted “Child Health Advisory Committee” for “committee” in (d)(1) and (e)(2).

20-7-136. Statewide fluoridation program — Definition.

1. As used in this section, “water system” means a facility including without limitation a parent system, consecutive system, or other system that holds, treats, and supplies water directly or through a consecutive system or consecutive systems to five thousand (5,000) persons or more.
2. The company, corporation, municipality, county, government agency, or other entity that owns or controls a water system shall control the quantity of fluoride in the water so as to maintain a fluoride content established by the Department of Health.
3. The State Board of Health shall adopt rules relating to the fluoridation of water systems that shall include without limitation:
   1. Permissible concentrations of fluoride to be maintained by a water system; and
   2. Requirements and procedures for maintaining permissible concentrations of fluoride including without limitation:
      1. Necessary equipment;
      2. Recordkeeping;
      3. Reporting; and
      4. Testing.
4. 1. A water system required to fluoridate under this section is not required to comply with the requirements of this section until funds sufficient to pay capital start-up costs for fluoridation equipment for the system have become available from any source other than tax revenue or service revenue regularly collected by the company, corporation, municipality, county, or other government agency that owns or controls the water system.
   2. A licensed civil engineer recognized or employed by the department who is familiar with the design, construction, operation, and maintenance of fluoridation systems shall determine for the department whether the capital start-up costs claimed under subdivision (d)(1) of this section are reasonable.
5. A water system for a city in this state that receives its water supply from a community in another state is not required to comply with this section until a substantially similar fluoridation program is enacted for the water system of the community in the other state.

History. Acts 2011, No. 197, § 1.

20-7-137. Soccer goal safety — Definition.

1. 1. As used in this section, “public recreation area” means an area that is used by members of the public for recreational activities.
   2. “Public recreation area” includes a privately owned or publicly owned:
      1. Park;
      2. Sports field;
      3. Auditorium;
      4. School playground; or
      5. Other school facility.
2. A soccer goal in a public recreation area shall be anchored according to the Guidelines for Movable Soccer Goal Safety promulgated by the United States Consumer Product Safety Commission as in effect on February 1, 2011, or the guidelines adopted by the Department of Health.
3. The department shall develop and adopt guidelines for soccer goal safety as provided under this section.

History. Acts 2011, No. 772, § 2.

A.C.R.C. Notes. Acts 2011, No. 772, § 1, provided:

“The General Assembly finds that:

“(1) On January 26, 2011, a tragic incident occurred when Jonathan Brian Nelson, who was nine (9) years of age, died of injuries sustained when an unanchored soccer goal fell on his head at Elm Tree Elementary School in Bentonville;

“(2) There are approximately five hundred thousand (500,000) soccer goals in the United States, and many of these soccer goals are unsafe because they are improperly designed, manufactured, or installed;

“(3) Problems arise with instability of movable soccer goals when they are unanchored, not properly anchored, or not properly counterbalanced;

“(4) Unstable soccer goals pose an unnecessary risk of tip-over to children who climb on the goals or nets or hang from the crossbar and can cause catastrophic injury to persons around the soccer goal;

“(5) There were at least nine (9) children under the age of sixteen (16) killed in accidents involving movable soccer goals between 1998 and mid-2010 and two thousand (2,000) serious injuries during this same period, according to the United States Consumer Products Safety Commission; and

“(6) This act is necessary to ensure the safety of children around soccer goals at schools and other recreational areas in the state.”

20-7-138. [Repealed.]

Publisher's Notes. This section, concerning low voltage carbon monoxide detectors required in new home construction, was repealed by Act 2013, No. 565, § 1. The section was derived from Acts 2011, No. 146, § 1.

20-7-139. [Repealed.]

Publisher's Notes. This section, concerning rules for the home visitation program, was repealed by Acts 2017, No. 896, § 2. The section was derived from Acts 2013, No. 528, § 2.

20-7-140. Arkansas standards for human breast milk.

1. The Department of Health shall establish, by rule, standards for transporting, processing, and distributing commercial human breast milk on a for-profit or nonprofit basis in this state.
2. The department may:
   1. Convene a committee of subject matter experts to assist in the development of the standards described in subsection (a) of this section; and
   2. Develop programs to encourage the creation of nonprofit human breast milk depositories and banks, if funding is available.

History. Acts 2019, No. 216, § 1.

Subchapter 2 — Arkansas Health Department Building and Local Grant Act

Publisher's Notes. Acts 1993, No. 350, § 7, provided:

“(a) All powers, functions and duties heretofore vested in and exercised by the Health Building Commission are hereby transferred to and shall hereafter be vested in the State Board of Health.

“(b) All funds appropriated to and all property, both real and personal, vested in the Health Building Commission are hereby transferred and shall be made available to the State Board of Health.

“(c) The Health Building Commission is hereby abolished.”

Effective Dates. Acts 1991, No. 1162, § 15: Apr. 10, 1991. Emergency clause provided: “It is hereby found and determined by the General Assembly that the Arkansas Department of Health is critically in need of additional space and that, accordingly, the expansion, which is authorized and enabled by this act, must be constructed as soon as feasible. Therefore, an emergency is declared to exist and this act being necessary for the preservation of the public peace, health and safety, shall be in force upon its passage and approval.”

Acts 1993, No. 350, § 11: Mar. 3, 1993. Emergency clause provided: “It is hereby found and determined by the General Assembly that the Arkansas Department of Health is critically in need of additional space and that, accordingly, the authorization to construct or acquire space enabled by this act, must be obtained as soon as feasible. Therefore, an emergency is hereby declared to exist and this act being necessary for the immediate preservation of the public peace, health and safety shall be in full force and effect from and after its passage and approval.”

Acts 2019, No. 910, § 6346(b): July 1, 2019. Emergency clause provided: “It is found and determined by the General Assembly of the State of Arkansas that this act revises the duties of certain state entities; that this act establishes new departments of the state; that these revisions impact the expenses and operations of state government; and that the sections of this act other than the two uncodified sections of this act preceding the emergency clause titled ‘Funding and classification of cabinet-level department secretaries’ and ‘Transformation and Efficiencies Act transition team’ should become effective at the beginning of the fiscal year to allow for implementation of the new provisions at the beginning of the fiscal year. Therefore, an emergency is declared to exist, and Sections 1 through 6343 of this act being necessary for the preservation of the public peace, health, and safety shall become effective on July 1, 2019”.

20-7-201. Title.

This subchapter may be known and may be cited as the “Arkansas Health Department Building and Local Grant Act”.

History. Acts 1989, No. 749, § 1.

20-7-202. Definitions.

As used in this subchapter:

1. 1. “Acquire” means to lease, lease-purchase, or purchase any lands, buildings, structures, improvements, or other property, real, personal, or mixed.
   2. “Acquire” also includes payment or provision for payment of all expenses incidental thereto;
2. [Repealed.]
3. 1. “Construct” means to acquire, construct, reconstruct, renovate, remodel, install, and equip any lands, buildings, structures, improvements, or other property, real, personal, or mixed, useful in connection with any expansion or acquisition and to make other necessary expenditures in connection therewith by the methods and in the manner as may be authorized by law and in the case of an acquisition of equipment and other property of a medical, laboratory, or technical nature, by the method the Secretary of the Department of Health shall determine to be necessary or desirable to accomplish the power, purposes, and authorities set forth in this subchapter and without regard to the provisions of other laws pertaining to the construction and acquisition of property by state agencies.
   2. “Construct” also includes payment or provision for payment for all expenses incidental thereto;
4. [Repealed.]
5. [Repealed.]
6. “Fees” means all fees set forth in § 20-7-123(b), which are confirmed and ratified by this subchapter; and
7. “Fund” means the State Health Department Building and Local Grant Trust Fund.

History. Acts 1989, No. 749, § 1; 1993, No. 350, § 1; 2019, No. 389, §§ 3, 4; 2019, No. 910, § 4935.

Amendments. The 2019 amendment by No. 389 repealed (2) and (5).

The 2019 amendment by No. 910 repealed (4).

20-7-203. Disposition of funds.

1. The Secretary of the Department of Health may construct or acquire such facilities and property as are necessary for the provision of current and future requirements for the Department of Health.
2. Notwithstanding other provisions of this subchapter, the secretary, with the approval of the State Board of Health, may use any unobligated funds in the State Health Department Building and Local Grant Trust Fund in an amount not to exceed six hundred fifty thousand dollars ($650,000) to construct or acquire any land, building, structure, or other property, real, personal, or mixed, and any expenses incidental thereto which are deemed appropriate for the provision of current and future requirements for the department.
3. With the approval of the board, the secretary may lease, sublease, or otherwise negotiate for the use of any space acquired or constructed under this subchapter to other governmental and nongovernmental entities. Revenues derived from any such lease, sublease, or other arrangement shall be deposited into the Public Health Fund.
4. Neither the secretary nor any member of the board shall be personally liable for any obligation or action undertaken in connection therewith or for any damages sustained by anyone with respect to any obligations or actions unless he or she shall have acted with a corrupt intent.

History. Acts 1989, No. 749, § 1; 1991, No. 1162, § 14; 1993, No. 350, § 2; 2019, No. 910, § 4936.

Amendments. The 2019 amendment substituted “Secretary of the Department of Health” for “Director of the Department of Health” in (a); and substituted “secretary” for “director” throughout the section.

20-7-204. State Health Department Building and Local Grant Trust Fund.

1. There is established on the books of the Treasurer of State, Auditor of State, and Chief Fiscal Officer of the State a fund to be known as the “State Health Department Building and Local Grant Trust Fund”.
2. The fund shall consist of such revenues as may be authorized by law, including a portion collected under § 20-7-129 and § 20-7-408(f).
3. The Secretary of the Department of Health shall be the disbursing agent and executive officer for the fund.
4. The fund shall be a continuing fund, not subject to fiscal year limitations, and, except as provided in § 20-7-203(b), shall only be used for expansion, renovation, construction, or improvements to the Department of Health building and for grants for construction, renovation, or other expansion of approved local health unit facilities in this state.
5. No money from the fund may be used for the acquisition, purchase, lease, or otherwise, of real property for any local health unit facility.

History. Acts 1989, No. 749, § 1; 1993, No. 350, § 3; 2017, No. 206, § 3; 2017, No. 752, § 2; 2019, No. 910, § 4937.

Amendments. The 2017 amendment by No. 206 substituted “a portion collected under § 20-7-129” for “the portion of client visit fees specified in § 20-7-127” in (b).

The 2017 amendment by No. 752 added “and § 20-7-408(f)” in (b).

The 2019 amendment substituted “Secretary of the Department of Health” for “Director of the Department of Health” in (c).

20-7-205. Rules — Application for grants.

1. 1. The State Board of Health may develop and implement rules to receive, review, and approve applications for grants for new construction, renovation, or expansion of local health unit facilities from counties or cities.
   2. The board may adopt such rules as may be necessary to provide for the distribution of such funds for the renovation, construction, improvement, and development of the State Health Building.
2. Except as provided in subsection (c) of this section, any grant approved by the board to a county or city for the development of a local public health facility project shall require ten percent (10%) local matching funds from the city or county applicant. The matching funds may be in the form of either cash or an in-kind match, to be determined by the board. The value of existing buildings and property shall not qualify for local matching funds under this section.
3. The board may also establish by rule a special program to address renovation of local health units due to special requirements of the Department of Health. The programs shall provide for grants of up to ten thousand dollars ($10,000). The local match may be waived for the special grants.
4. 1. Application for grants under this subchapter shall be made in accordance with the rules of the board, and each application shall be considered on a needs-assessment basis.
   2. In addition, the applicant city or county shall furnish proof of the following with each grant application:
      1. Local community involvement in the project;
      2. Existence of resources to expand existing facilities, including availability of land;
      3. A design of the proposed project; and
      4. Evidence of need, including factors such as population growth, additional services to be offered, and increased workload.

History. Acts 1989, No. 749, § 1; 2019, No. 315, §§ 1816, 1817.

Amendments. The 2019 amendment deleted “and regulations” following “rules” throughout the section.

20-7-206. Participation conditioned.

Participation in the grant programs shall be conditioned on compliance with this subchapter and any rules or regulations of the State Board of Health promulgated under this subchapter.

History. Acts 1989, No. 749, § 1.

Subchapter 3 — State Health Data Clearinghouse Act

A.C.R.C. Notes. References to “this subchapter” in §§ 20-7-301 — 20-7-308 may not apply to § 20-7-310, which was enacted subsequently.

Effective Dates. Acts 1997, No. 179, § 38: Feb. 17, 1997. Emergency clause provided: “It is hereby found and determined by the General Assembly that Act 10 of the First Extraordinary Session of 1995 abolished the Joint Interim Committee on Public Health, Welfare, and Labor and in its place established the House Interim Committee and Senate Interim Committee on Public Health, Welfare, and Labor; that various sections of the Arkansas Code refer to the Joint Interim Committee on Public Health, Welfare, and Labor and should be corrected to refer to the House and Senate Interim Committees on Public Health, Welfare, and Labor; that this act so provides; and that this act should go into effect immediately in order to make the laws compatible as soon as possible. Therefore, an emergency is declared to exist and this act being immediately necessary for the preservation of the public peace, health and safety shall become effective on the date of its approval by the Governor. If the bill is neither approved nor vetoed by the Governor, it shall become effective on the expiration of the period of time during which the Governor may veto the bill. If the bill is vetoed by the Governor and the veto is overridden, it shall become effective on the date the last house overrides the veto.”

Acts 2003, No. 999, § 4[5]: Apr. 1, 2003. Emergency clause provided: “It is found and determined by the General Assembly of the State of Arkansas that the federal District Courts for the Eastern and Western Districts of Arkansas have held the state's school immunization statute to be unconstitutional, that the courts have stayed the effect of the finding, that if the stay is lifted before this act becomes effective, some students will be excluded from school attendance. Therefore, an emergency is declared to exist and this act being immediately necessary for the preservation of the public peace, health, and safety shall become effective on: (1) The date of its approval by the Governor; (2) If the bill is neither approved nor vetoed by the Governor, the expiration of the period of time during which the Governor may veto the bill; or (3) If the bill is vetoed by the Governor and the veto is overridden, the date the last house overrides the veto.”

Acts 2019, No. 910, § 6346(b): July 1, 2019. Emergency clause provided: “It is found and determined by the General Assembly of the State of Arkansas that this act revises the duties of certain state entities; that this act establishes new departments of the state; that these revisions impact the expenses and operations of state government; and that the sections of this act other than the two uncodified sections of this act preceding the emergency clause titled ‘Funding and classification of cabinet-level department secretaries’ and ‘Transformation and Efficiencies Act transition team’ should become effective at the beginning of the fiscal year to allow for implementation of the new provisions at the beginning of the fiscal year. Therefore, an emergency is declared to exist, and Sections 1 through 6343 of this act being necessary for the preservation of the public peace, health, and safety shall become effective on July 1, 2019”.

20-7-301. Title.

This subchapter shall be entitled the “State Health Data Clearinghouse Act”.

History. Acts 1995, No. 670, § 1.

20-7-302. Purpose.

The General Assembly finds that as a result of rising healthcare costs, the shortage of health professionals and healthcare services in many areas of the state, and the concerns expressed by care providers, consumers, third-party payors, and others involved with planning for the provision of health care, there is an urgent need to understand patterns and trends in the availability, use, and costs of these services. Therefore, to establish an information base for patients, health professionals, and hospitals, to improve the appropriate and efficient usage of healthcare services, and to provide for appropriate protection for confidentiality and privacy, the Department of Health shall act as a state health data clearinghouse for the acquisition and dissemination of data from state agencies and other appropriate sources to carry out this subchapter.

History. Acts 1995, No. 670, § 2.

20-7-303. Collection and dissemination of health data.

1. With the approval of the State Board of Health, the Secretary of the Department of Health shall compile and disseminate health data collected by the Department of Health.
2. 1. In consultation with advisory groups appointed by the secretary with representation from hospitals, outpatient surgery centers, health profession licensing boards, and other state agencies, the department should:
      1. Identify the most practical methods to collect, transmit, and share required health data as described in § 20-7-304;
      2. Utilize, wherever practical, existing administrative databases and modalities of data collection to provide the required data;
      3. Develop standards of accuracy, timeliness, economy, and efficiency for the provision of the data; and
      4. Ensure confidentiality of data by enforcing appropriate rules.
   2. To maximize limited resources and to prevent duplication of effort, the department may consider, when appropriate, contracting with private entities for the collection of data as set forth in this section subject to this subchapter.
3. 1. All state agencies, including health profession licensing, certification, or registration boards and commissions, which collect, maintain, or distribute health data, including data relating to the Arkansas Medicaid Program, shall make available to the department such data as are necessary for the department to carry out its responsibilities under this subchapter or such rules as may be adopted as provided in § 20-7-305.
   2. If health data are already reported to another organization or governmental agency in the same manner, form, and content or in a manner, form, and content acceptable to the department, the secretary may obtain a copy of the data from the organization or agency, and no duplicate report need be submitted by the organization.
   3. All hospitals and outpatient surgery centers licensed by the state shall submit information in a form and manner as prescribed by rules by the State Board of Health pursuant to § 20-7-305. However, if the same information is being collected by another state agency, the department shall obtain the data from the other state agency.

History. Acts 1995, No. 670, § 2; 2019, No. 315, §§ 1818-1820; 2019, No. 910, §§ 4938, 4939.

Amendments. The 2019 amendment by No. 315 deleted “and regulations” following “rules” throughout the section.

The 2019 amendment by No. 910 substituted “Secretary of the Department of Health” for “Director of the Department of Health” in (a); and substituted “secretary” for “director” in the introductory language of (b)(1) and in (c)(2).

20-7-304. Release of health data.

The Secretary of the Department of Health may release data collected under this subchapter, except that data released shall not include any information which identifies or could be used to identify any individual patient, provider, institution, or health plan except as provided in § 20-7-305.

History. Acts 1995, No. 670, § 2; 2019, No. 910, § 4940.

Amendments. The 2019 amendment substituted “Secretary of the Department of Health” for “Director of the Department of Health”.

20-7-305. State Board of Health to prescribe rules — Data collected not subject to discovery.

1. The State Board of Health shall prescribe and enforce such rules as may be necessary to carry out this subchapter, including the manner in which data are collected, maintained, compiled, and disseminated, and including such rules as may be necessary to promote and protect the confidentiality of data reported under this subchapter.
2. Data provided, collected, or disseminated under this subchapter which identifies, or could be used to identify, any individual patient, provider, institution, or health plan shall not be subject to discovery pursuant to the Arkansas Rules of Civil Procedure or the Freedom of Information Act of 1967, § 25-19-101 et seq.
3. 1. 1. The Department of Human Services may provide data only for purposes of research and aggregate statistical reporting to the Arkansas Center for Health Improvement, the United States Agency for Healthcare Research and Quality for its Healthcare Cost and Utilization Project, or other researchers for research projects approved by the Department of Health under rules promulgated by the State Board of Health that provide for appropriate security and confidentiality protections for the data.
      2. The Department of Human Services also shall provide data to the Arkansas Hospital Association, Inc. for its price transparency and consumer-driven healthcare project that will make price and quality information about Arkansas hospitals available to the general public.
   2. The data shall be treated in a manner consistent with all state and federal privacy requirements, including, without limitation, the federal Health Insurance Portability and Accountability Act of 1996 privacy rule, specifically 45 C.F.R. § 164.512(i).
   3. Any identifiable data provided, collected, or disseminated under this subsection shall not be subject to discovery pursuant to the Arkansas Rules of Civil Procedure or the Freedom of Information Act of 1967, § 25-19-101 et seq.
4. It shall be unlawful for the hospital or outpatient surgery center to release any patient-identifying information to any nongovernmental third party.

History. Acts 1995, No. 670, § 2; 2005, No. 1434, § 1; 2007, No. 616, § 1; 2019, No. 315, § 1821.

Amendments. The 2019 amendment deleted “and regulations” following “rules” in (a).

20-7-306. Reports — Assistance.

1. The Secretary of the Department of Health shall prepare and submit a biennial report to the Governor and the House Committee on Public Health, Welfare, and Labor and the Senate Committee on Public Health, Welfare, and Labor or appropriate subcommittees thereof.
2. The Department of Health shall provide assistance to the House Committee on Public Health, Welfare, and Labor and the Senate Committee on Public Health, Welfare, and Labor or appropriate subcommittees thereof in the development of information necessary in the examination of healthcare issues.
3. 1. With regard to § 6-18-702(d), § 6-60-504(b), and § 20-78-206(a)(2)(B), the department shall report every six (6) months to the House Committee on Public Health, Welfare, and Labor and the Senate Committee on Public Health, Welfare, and Labor regarding:
      1. The geographic patterns of exemptions, vaccination rates, and exemptions in those areas as well as the rest of the state; and
      2. Disease incidence of vaccine-preventable diseases collected by the department.
   2. The collection of exemption information shall begin January 4, 2004.
   3. Reports shall begin at the first interim meeting of the House Committee on Public Health, Welfare, and Labor and the Senate Committee on Public Health, Welfare, and Labor.

History. Acts 1995, No. 670, § 2; 1997, No. 179, § 22; 2003, No. 999, § 4; 2007, No. 827, § 148; 2019, No. 910, § 4941.

Amendments. The 2019 amendment substituted “Secretary of the Department of Health” for “Director of the Department of Health” in (a).

20-7-307. Penalties.

1. 1. Any person, firm, corporation, organization, or institution that violates any of the provisions of this subchapter or any rules promulgated under this subchapter regarding confidentiality of information shall be guilty of a Class C misdemeanor.
   2. Each day of violation shall constitute a separate offense.
2. Any person, firm, corporation, organization, or institution knowingly violating any of the provisions of this subchapter or any rules promulgated under this subchapter shall be guilty of a violation and upon conviction shall be punished by a fine of not more than five hundred dollars ($500).
3. 1. Every person, firm, corporation, organization, or institution that violates any of the rules adopted by the State Board of Health or that violates any provision of this subchapter may be assessed a civil penalty by the board.
   2. The civil penalty shall not exceed two hundred fifty dollars ($250) for each violation.
   3. However, no civil penalty may be assessed until the person charged with the violation has been given the opportunity for a hearing on the violation pursuant to the Arkansas Administrative Procedure Act, § 25-15-201 et seq.

History. Acts 1995, No. 670, § 3; 2005, No. 1994, § 243; 2019, No. 315, §§ 1822-1824.

Amendments. The 2019 amendment deleted “and regulations” following “rules” throughout the section.

20-7-308. Repealer.

All laws and parts of laws in conflict with this subchapter are repealed, except that nothing in this subchapter shall be interpreted to repeal any provision which authorizes the Health Services Permit Agency to gather such data as may be necessary to conduct permit-of-approval activities.

History. Acts 1995, No. 670, § 6.

20-7-309. List of substances used to alter samples in drug or alcohol screening tests.

The Department of Health shall maintain and update as part of its database under this subchapter a list of substances that may be used to adulterate urine or other bodily fluids that may be used in or used to interfere with a drug or alcohol screening test.

History. Acts 2003, No. 750, § 1.

20-7-310. Construction with other laws.

Nothing in this act shall be construed to encourage, conflict, or otherwise interfere with the preemption of state and local laws under any federal laws or United States Department of Transportation regulations related to drug testing procedures and confidentiality.

History. Acts 2003, No. 750, § 2.

Publisher's Notes. References to “this subchapter” in §§ 20-7-301 — 20-7-308 may not apply to this section, which was enacted subsequently.

Acts 2003, No. 750, § 2, is also codified as § 5-60-202.

Meaning of “this act”. Acts 2003, No. 750, codified as §§ 5-60-201, 5-60-202, 20-7-309 and 20-7-310.

Subchapter 4 — Department of Health Public Health Laboratory Act of 2003

Effective Dates. Acts 2019, No. 910, § 6346(b): July 1, 2019. Emergency clause provided: “It is found and determined by the General Assembly of the State of Arkansas that this act revises the duties of certain state entities; that this act establishes new departments of the state; that these revisions impact the expenses and operations of state government; and that the sections of this act other than the two uncodified sections of this act preceding the emergency clause titled ‘Funding and classification of cabinet-level department secretaries’ and ‘Transformation and Efficiencies Act transition team’ should become effective at the beginning of the fiscal year to allow for implementation of the new provisions at the beginning of the fiscal year. Therefore, an emergency is declared to exist, and Sections 1 through 6343 of this act being necessary for the preservation of the public peace, health, and safety shall become effective on July 1, 2019”.

20-7-401. Title.

This subchapter shall be known and may be cited as the “Department of Health Public Health Laboratory Act of 2003”.

History. Acts 2003, No. 1723, § 1.

20-7-402. Purpose.

It is the purpose of this subchapter to better serve the citizens of Arkansas by providing for the construction and equipping of a modern public health laboratory.

History. Acts 2003, No. 1723, § 2.

20-7-403. Definitions.

As used in this subchapter:

1. “Authority” means the Arkansas Development Finance Authority;
2. “Authorizing resolution” means the resolution or resolutions adopted by the State Board of Health authorizing the loan;
3. [Repealed.]
4. “Building” means the state building of the Department of Health located on West Markham Street in Little Rock;
5. “Construct” means to acquire, construct, reconstruct, remodel, install, and equip any lands, buildings, structures, improvements, or other property, whether real, personal, or mixed, useful in connection with the expansion, by any method and manner as may be authorized by law, and in the case of the acquisition of equipment and other property of a medical, laboratory, or technical nature, by any method as the board or the Secretary of the Department of Health determines to be necessary or desirable to accomplish the power, purposes, and authorities set forth in this subchapter and without regard to the provisions of other laws pertaining to the construction and acquisition of property by state agencies;
6. “Construction fund” means the State Board of Health Public Health Laboratory Construction Fund;
7. [Repealed.]
8. “Fee revenues” means all revenues derived from all or any of the fees;
9. “Fees” means the fees generated under this subchapter that represent an increase to the allowable fees set forth in § 20-7-123;
10. “Laboratory” means a public health laboratory that is a modern stand-alone public health laboratory to be constructed on the existing site of the department located on West Markham Street in Little Rock;
11. “Loan” means the loan which the board may effect from the authority by the terms of this subchapter;
12. “Renovation” means the renovation and improvement of the building, including the renovation and alteration of existing properties, whether real, personal, or mixed;
13. “Revenue fund” means the State Board of Health Laboratory Revenue Fund; and
14. “Revenue loan fund” means the State Board of Health Laboratory Revenue Loan Fund.

History. Acts 2003, No. 1723, § 3; 2019, No. 389, §§ 5, 6; 2019, No. 910, §§ 4942, 4943.

Amendments. The 2019 amendment by No. 389 repealed (3) and (7).

The 2019 amendment by No. 910 substituted “Secretary of the Department of Health” for “Director of the Department of Health” in (5); and repealed (7).

20-7-404. Approval of construction.

1. 1. The laboratory shall be constructed subject to approval by the State Board of Health.
   2. The board may take such action as may be appropriate for the renovation of the building and any facilities necessarily related to the building.
2. Subject to the approval of the board, the plans, specifications, and estimates of cost for the laboratory and renovation of the building shall be developed by the Secretary of the Department of Health, and the secretary may employ architects and other like professional and technical assistance as determined to be necessary for the construction of the laboratory and renovation of the building.
3. The board and the secretary may take such action as may be appropriate for the construction of the laboratory and renovation of the building to accomplish the purposes of this subchapter and may engage legal, technical, and other assistance as necessary.

History. Acts 2003, No. 1723, § 4; 2019, No. 910, § 4944.

Amendments. The 2019 amendment substituted “Secretary of the Department of Health” for “Director of the Department of Health” in (b); and substituted “secretary” for “director” in (b) and (c).

20-7-405. Financing of construction and renovation.

1. 1. To finance the construction of the laboratory and renovation of the building, the State Board of Health may enter into a loan from the Arkansas Development Finance Authority in the principal amount of not more than twenty-six million dollars ($26,000,000) under the Arkansas Development Finance Authority Act, § 15-5-101 et seq., § 15-5-201 et seq., and § 15-5-301 et seq.
   2. The amount and purpose of the loan shall be approved by the board in an authorizing resolution, copies of which shall be maintained in the records of the board and of the authority.
2. The loan shall bear interest at a rate determined by the rate of interest on funds borrowed by the authority to fund the loan but not to exceed the lesser of ten percent (10%) per annum or the maximum rate of interest permitted by the Arkansas Constitution.
3. The loan shall mature over a period of not more than thirty (30) years.
4. The board and the Secretary of the Department of Health may execute and deliver agreements, instruments, and other undertakings and writings and take such action as may be appropriate to evidence the loan and the security for the loan and to carry out this subchapter.

History. Acts 2003, No. 1723, § 5; 2019, No. 910, § 4945.

Amendments. The 2019 amendment substituted “Secretary of the Department of Health” for “Director of the Department of Health” in (d).

20-7-406. Security for indebtedness.

1. The payment and other obligations of the State Board of Health under and with respect to the loan shall be secured by a pledge of the fee revenues, subject to the terms of this subchapter and the reserved power to release fee revenues as set forth in this subchapter.
2. The loan shall be an obligation of the board only and shall not constitute an indebtedness for which the faith and credit of the State of Arkansas or any of its revenues are pledged.
3. The loan shall not be secured by a lien on any land, building, or other property belonging to the State of Arkansas.
4. The loan shall not constitute an indebtedness within the meaning of any constitutional or statutory limitation.

History. Acts 2003, No. 1723, § 6.

20-7-407. Fees.

In addition to the fees authorized by § 20-7-123(b)(1)(H) and (I), the following fees shall be collected and credited to the State Board of Health Laboratory Revenue Fund:

1. A fee of seven dollars ($7.00) collected by the State Registrar of Vital Records for the making and certification of any birth certificate or record;
2. A fee of five dollars ($5.00) collected for the making and certification of each additional copy of any birth certificate or record;
3. A fee of six dollars ($6.00) collected by the registrar for the making and certification of a single copy of a death certificate;
4. A fee of seven dollars ($7.00) collected by the registrar for the making and certification of each additional copy of a death certificate;
5. A fee of five dollars ($5.00) collected by the registrar for the making and certification of any marriage or divorce certificate or record;
6. A fee of five dollars ($5.00) collected by the registrar for the making and certification of each additional copy of any marriage or divorce certificate or record;
7. A fee of seven dollars ($7.00) collected by the registrar for an examination and search of the files for any birth record;
8. A fee of five dollars ($5.00) collected by the registrar for an examination and search of the files for any marriage or divorce record; and
9. A fee of six dollars ($6.00) collected by the registrar for an examination and search of the files for any death record.

History. Acts 2003, No. 1723, § 7.

Publisher's Notes. As enacted by Acts 2003, No. 1723, subsection (a) began: “Effective September 1, 2003,”.

20-7-408. Disposition of certain fees.

1. 1. Except as set forth in this subchapter, all fee revenues shall be treated as cash funds and shall not be deposited into the State Treasury, but shall be deposited as and when received into a bank or banks approved by the State Board of Health or the Secretary of the Department of Health in an account or accounts of the board designated the “State Board of Health Laboratory Revenue Fund”.
   2. So long as the loan is outstanding, all moneys in the State Board of Health Laboratory Revenue Fund shall not be subject to the provisions of §§ 19-4-801 — 19-4-803, 19-4-804 [repealed], 19-4-805, and 19-4-806 and shall be deposited, handled, and disbursed as set forth in this subchapter.
2. Moneys held in the State Board of Health Laboratory Revenue Fund shall be withdrawn and deposited no less frequently than bimonthly as follows and in the following order of priority:
   1. An annual amount sufficient to provide for principal, interest, servicing fees, and reserve requirements with respect to the loan but not to exceed two million six hundred thousand dollars ($2,600,000) per fiscal year:
      1. Before the commencement of the loan, in the State Board of Health Public Health Laboratory Construction Fund; and
      2. Beginning upon commencement of the loan, in an account or accounts in the name of the board or the Arkansas Development Finance Authority, as determined by the board and the authority, designated the “State Board of Health Laboratory Revenue Loan Fund”; and
   2. Any balance remaining shall be distributed fifty percent (50%) to the Public Health Fund and fifty percent (50%) to the State Health Department Building and Local Grant Trust Fund.
3. 1. All funds held in the State Board of Health Laboratory Revenue Fund, the State Board of Health Laboratory Revenue Loan Fund, and the State Board of Health Public Health Laboratory Construction Fund shall be deemed to be cash funds, shall not be deposited into the State Treasury, and shall be transferred, deposited, and applied as set forth in this subchapter without the necessity of appropriation.
   2. All transfers from the State Board of Health Laboratory Revenue Fund and the State Board of Health Public Health Laboratory Construction Fund shall be made by or at the direction of the secretary.
   3. All transfers from the State Board of Health Laboratory Revenue Loan Fund shall be made by:
      1. The secretary; or
      2. The authority, if approved by the board.
4. So long as the loan is outstanding, funds held in the State Board of Health Laboratory Revenue Loan Fund shall be used solely for the purpose of paying and providing for the principal of, interest on, and servicing fees, if any, in connection with the loan and providing for the creation and maintenance of necessary reserves. The funds may be pledged by the board to secure the loan and may be pledged and used by the authority to pay and secure bonds issued by the authority to finance the construction.
5. 1. So long as the loan is outstanding, all fees shall be imposed and all fee revenues shall be collected and applied as provided in this subchapter.
   2. However, particular fees may be reduced or eliminated so long as remaining fees are increased or new fees are added to the end that the aggregate annual amount of fee revenues shall always equal at least three million dollars ($3,000,000).
6. Upon payment or discharge of the loan and all bonds issued by the authority under this subchapter, the fees authorized by this subchapter shall be deposited into the State Health Department Building and Local Grant Trust Fund.

History. Acts 2003, No. 1723, § 8; 2017, No. 752, § 3; 2019, No. 910, §§ 4946-4948.

Amendments. The 2017 amendment substituted “be deposited into the State Health Department Building and Local Grant Trust Fund” for “terminate” in (f).

The 2019 amendment substituted “Secretary of the Department of Health” for “Director of the Department of Health” in (a)(1); and substituted “secretary” for “director” in (c)(2) and (c)(3)(A).

20-7-409. State Board of Health Public Health Laboratory Construction Fund.

The proceeds of the loan other than amounts required to establish reserves, to pay interest on the loan for a period not to exceed one (1) year, or to pay costs of the loan and of issuing bonds, all of which shall be set forth in written directions executed by the Secretary of the Department of Health, shall be deposited as cash funds into an account of the State Board of Health designated the “State Board of Health Public Health Laboratory Construction Fund” and disbursed by the secretary for the construction of the expansion.

History. Acts 2003, No. 1723, § 9; 2019, No. 910, § 4949.

Amendments. The 2019 amendment substituted “Secretary of the Department of Health” for “Director of the Department of Health” and substituted “secretary” for “director”.

20-7-410. Investment of funds.

1. All moneys held at any time in the State Board of Health Laboratory Revenue Fund and the State Board of Health Public Health Laboratory Construction Fund shall be invested and reinvested to the extent feasible, as directed by the Secretary of the Department of Health.
2. All moneys held in the State Board of Health Laboratory Revenue Loan Fund shall be invested and reinvested to the extent feasible, as directed by the Arkansas Development Finance Authority, in securities which are eligible for the securing of public deposits under § 19-8-203, subject in all cases to the term of the loan and of bonds issued by the authority.

History. Acts 2003, No. 1723, § 10; 2019, No. 910, § 4950.

Amendments. The 2019 amendment substituted “Secretary of the Department of Health” for “Director of the Department of Health” in (a).

20-7-411. Formation of contracts.

1. The authorizing resolution and each agreement or other writing executed and delivered pursuant to it or to this subchapter, together with this subchapter, shall constitute a contract between the State Board of Health and the Arkansas Development Finance Authority, and the obligations of the board may be enforced by mandamus or other equitable or legal remedy.
2. The obligations of the board shall be freely assignable by the authority, provided that the board is notified in writing of the assignment.

History. Acts 2003, No. 1723, § 11.

20-7-412. Limitations on liability.

Neither the Secretary of the Department of Health nor any member of the State Board of Health shall be personally liable on the loan or on account of any of the obligations or actions undertaken in connection with the loan, or for any damages sustained by anyone with respect to the obligations or actions, unless he or she acted with a corrupt intent.

History. Acts 2003, No. 1723, § 12; 2019, No. 910, § 4951.

Amendments. The 2019 amendment substituted “Secretary of the Department of Health” for “Director of the Department of Health”.

Subchapter 5 — Arkansas Health-Conscious Shopper Act

20-7-501. Title.

This subchapter shall be known and may be cited as the “Arkansas Health-Conscious Shopper Act”.

History. Acts 2007, No. 48, § 1.

20-7-502. Findings — Intent.

1. The General Assembly finds that shopping cart handles may be contaminated with bodily fluids such as blood, saliva, mucus, and even urine and fecal matter.
2. This subchapter is intended to:
   1. Increase awareness of Arkansas shoppers, infants, and young children about potential contamination from contact with a shopping cart handle;
   2. Provide a barrier of protection between a shopper and a shopping cart handle; and
   3. Prevent the spread of viruses or bacteria.

History. Acts 2007, No. 48, § 1.

20-7-503. Arkansas Health-Conscious Shopper Program.

1. There is created the Arkansas Health-Conscious Shopper Program.
2. Under the program, each Arkansas business that uses shopping carts or infant carriers is encouraged to voluntarily provide consumers with sanitation wipes at the entrance of its business on or before January 1, 2008.

History. Acts 2007, No. 48, § 1.

20-7-504. Department of Health — Guidelines.

The Department of Health shall develop guidelines for businesses in the appropriate types and use of sanitation wipes for shopping cart handles.

History. Acts 2007, No. 48, § 1.

Subchapter 6 — Prescription Drug Monitoring Program Act

Effective Dates. Acts 2019, No. 910, § 6346(b): July 1, 2019. Emergency clause provided: “It is found and determined by the General Assembly of the State of Arkansas that this act revises the duties of certain state entities; that this act establishes new departments of the state; that these revisions impact the expenses and operations of state government; and that the sections of this act other than the two uncodified sections of this act preceding the emergency clause titled ‘Funding and classification of cabinet-level department secretaries’ and ‘Transformation and Efficiencies Act transition team’ should become effective at the beginning of the fiscal year to allow for implementation of the new provisions at the beginning of the fiscal year. Therefore, an emergency is declared to exist, and Sections 1 through 6343 of this act being necessary for the preservation of the public peace, health, and safety shall become effective on July 1, 2019”.

20-7-601. Title.

This subchapter shall be known and may be cited as the “Prescription Drug Monitoring Program Act”.

History. Acts 2011, No. 304, § 1.

20-7-602. Purpose.

The purpose of this subchapter is to protect the state health system and the citizens of Arkansas by:

1. Enhancing patient care by providing prescription monitoring information that will ensure legitimate use of controlled substances in health care, including palliative care, research, and other medical pharmacological uses;
2. Helping curtail the misuse and abuse of controlled substances;
3. Assisting in combating illegal trade in and diversion of controlled substances; and
4. Enabling access to prescription information by practitioners, law enforcement agents, and other authorized individuals and agencies and to make prescription information available to practitioners, law enforcement agents, and other authorized individuals and agencies in other states.

History. Acts 2011, No. 304, § 1.

20-7-603. Definitions.

As used in this subchapter:

1. 1. “Arkansas Medicaid prescription drug program” means the prescription drug program that is a portion of the Title XIX Medicaid program for the State of Arkansas.
   2. The Arkansas Medicaid prescription drug program includes any entity contracted with the Arkansas Medicaid prescription drug program and to which the Arkansas Medicaid Program has granted authority;
2. “Certified law enforcement prescription drug diversion investigator” means a certified law enforcement officer assigned by his or her law enforcement agency to investigate prescription drug diversion and who has completed a certification course in prescription drug diversion approved by the Prescription Drug Monitoring Program Advisory Committee and certified by the Arkansas Commission on Law Enforcement Standards and Training;
3. “Controlled substance” means a drug, substance, or immediate precursor in Schedules II-V;
4. “Dispense” means to deliver a controlled substance to an ultimate user or research subject by or pursuant to the lawful order of a practitioner, including without limitation the prescribing, administering, packaging, labeling, or compounding necessary to prepare the controlled substance for that delivery;
5. 1. “Dispenser” means a practitioner who dispenses.
   2. “Dispenser” does not include:
      1. A licensed hospital pharmacy when it is distributing controlled substances for the purpose of outpatient services, inpatient hospital care, or at the time of discharge from a hospital, except for a pharmacy owned by a hospital that has a retail pharmacy permit when the pharmacy is distributing controlled substances directly to the public;
      2. A wholesale distributor of Schedules II-V controlled substances; or
      3. A practitioner or other authorized person who administers a controlled substance;
6. “Exchangeability” means the ability of the program to electronically share reported information with another state's prescription monitoring program if the information concerns the dispensing of a controlled substance either:
   1. To a patient who resides in the other state; or
   2. Prescribed by a practitioner whose principal place of business is located in the other state;
7. “Investigation” means an active inquiry that is being conducted with a reasonable, good-faith belief that the inquiry:
   1. Could lead to the filing of administrative, civil, or criminal proceedings; or
   2. Is ongoing and continuing and a reasonable, good-faith anticipation exists for securing an arrest or prosecution in the foreseeable future;
8. “Opioid” means a drug or medication that relieves pain, including without limitation:
   1. Hydrocodone;
   2. Oxycodone;
   3. Morphine;
   4. Codeine;
   5. Heroin; and
   6. Fentanyl;
9. “Patient” means the person or animal who is the ultimate user of a controlled substance for whom a lawful prescription is issued and for whom a controlled substance is lawfully dispensed;
10. “Practitioner” means:
    1. A physician, dentist, veterinarian, advanced practice nurse, physician assistant, pharmacist, scientific investigator, or other person licensed, registered, or otherwise permitted to prescribe, distribute, dispense, conduct research with respect to, or to administer a controlled substance in the course of professional practice or research in this state; and
    2. A pharmacy, hospital, or other institution licensed, registered, or otherwise permitted to distribute, dispense, conduct research with respect to, or to administer a controlled substance in the course of professional practice or research in this state;
11. “Prescribe” means to issue a direction or authorization, by prescription, permitting a patient lawfully to obtain a controlled substance;
12. “Prescriber” means a practitioner or other authorized person who prescribes a Schedule II, III, IV, or V controlled substance;
13. “Prescription” means a controlled substance lawfully prescribed and subsequently dispensed;
14. “Prescription drug monitoring program” means a program that collects, manages, analyzes, and provides information regarding Schedule II, III, IV, and V controlled substances as provided under the Uniform Controlled Substances Act, § 5-64-101 et seq., §§ 5-64-1101 — 5-64-1103, the Food, Drug, and Cosmetic Act, § 20-56-201 et seq., or §§ 20-64-501 — 20-64-513;
15. “Qualified law enforcement agency” means a law enforcement agency that has a certified law enforcement prescription drug diversion investigator and a chief, sheriff, or law enforcement chief executive officer who has successfully completed a certification course in prescription drug diversion approved by the commission;
16. “Schedule II” means controlled substances that are placed in Schedule II under § 5-64-205;
17. “Schedule III” means controlled substances that are placed in Schedule III under § 5-64-207;
18. “Schedule IV” means controlled substances that are placed in Schedule IV under § 5-64-209;
19. “Schedule V” means controlled substances that are placed in Schedule V under § 5-64-211; and
20. “Ultimate user” means a person who lawfully possesses a controlled substance for:
    1. The person's own use;
    2. The use of a member of the person's household; or
    3. Administering to an animal owned by a person or by a member of the person's household.

History. Acts 2011, No. 304, § 1; 2015, No. 901, § 1; 2015, No. 1208, § 2; 2017, No. 46, § 1.

Amendments. The 2015 amendment by No. 901 added the definitions for “Certified law enforcement prescription drug diversion investigator” and “Qualified law enforcement agency”.

The 2015 amendment by No. 1208 added the definition for “Opiod”.

The 2017 amendment added the definition for “Arkansas Medicaid prescription drug program”.

20-7-604. Requirements for Prescription Drug Monitoring Program.

1. The State Board of Health shall create the Prescription Drug Monitoring Program upon the Department of Health's procuring adequate funding to establish the program.
2. 1. Each dispenser shall submit to the department information regarding each controlled substance dispensed.
   2. A dispenser located outside Arkansas and licensed and registered by the Arkansas State Board of Pharmacy shall submit to the department information regarding each controlled substance prescription dispensed to an ultimate user whose address is within Arkansas.
   3. The State Board of Health shall create a controlled substances database for the program.
3. Each dispenser required to report under subsection (b) of this section shall submit to the department by electronic means information that shall include without limitation:
   1. The dispenser's identification number;
   2. The date the prescription was filled;
   3. The prescription number;
   4. Whether the prescription is new or is a refill;
   5. The National Drug Code for the controlled substance that is dispensed;
   6. The quantity of the controlled substance dispensed;
   7. The number of days' supply dispensed;
   8. The number of refills ordered;
   9. 1. A patient identifier.
      2. A patient identifier shall not be a Social Security number or a driver's license number;
   10. The patient's name;
   11. The patient's address;
   12. The patient's date of birth;
   13. The patient's gender;
   14. The prescriber's identification number;
   15. The date the prescription was issued by the prescriber; and
   16. The source of the payment for the prescription.
4. 1. Except as required in subdivision (d)(2) of this section, practitioners are encouraged to access or check the information in the controlled substance database created under this subchapter before prescribing, dispensing, or administering medications.
   2. 1. A prescriber shall check the information in the program when prescribing:
         1. An opioid from Schedule II or Schedule III for every time prescribing the medication to a patient; and
         2. A benzodiazepine medication for the first time prescribing the medication to a patient.
      2. A licensing board that licenses practitioners who have the authority to prescribe shall adopt rules requiring the practitioners to check the information in the program as described in subdivision (d)(2)(A) of this section.
      3. This subdivision (d)(2) does not apply to:
         1. A practitioner administering a controlled substance:
            1. Immediately before or during surgery;
            2. During recovery from a surgery while in a healthcare facility;
            3. In a healthcare facility; or
            4. Necessary to treat the patient in an emergency situation at the scene of an emergency, in a licensed ground ambulance or air ambulance, or in the intensive care unit of a licensed hospital;
         2. A practitioner prescribing or administering a controlled substance to:
            1. A palliative care or hospice patient; or
            2. A resident in a licensed nursing home facility; or
         3. Situations in which the program is not accessible due to technological or electrical failure.
      4. The State Board of Health may amend, by rule, the exemptions listed in subdivision (d)(2)(C) of this section upon a recommendation from the Secretary of the Department of Health and a showing that the exemption or lack of exemption is unnecessarily burdensome or has created a hardship.
   3. A licensed oncologist shall check the program when prescribing to a patient on an initial malignant episodic diagnosis and every three (3) months following the diagnosis while continuing treatment.
5. This subchapter does not prohibit licensing boards from requiring practitioners to access or check the information in the controlled substance database as a part of a review of the practitioner's professional practice.
6. Each dispenser shall submit the required information in accordance with transmission methods and frequency established by the department.
7. 1. The department shall create a process for patients to address errors, inconsistencies, and other matters in their record as maintained under this section, including cases of breach of privacy and security.
   2. The department shall develop algorithms within the controlled substance database that would alert a practitioner if his or her patient is being prescribed opioids by more than three (3) physicians within any thirty-day period, if funding is available.
8. 1. The department shall limit access to only those employees whose access is reasonably necessary to carry out this section.
   2. However, a prescriber may delegate access to the controlled substance database to persons under his or her supervision or employment.
      1. A certified law enforcement prescription drug diversion investigator shall provide to the department the following information in order to be granted access to the program:
      1. Written verification that the inquiries were part of a lawful prescription drug diversion investigation as provided to the department through the case number of the investigation; and
      2. The disposition of the investigation.
   3. 1. The verification form under subdivision (j)(2) of this section shall be submitted to the department within thirty (30) days of receipt of the form by the qualified law enforcement agency.
      2. Failure to submit a verification form under subdivision (j)(3)(A) of this section shall result in the immediate suspension of access to the database by the qualified law enforcement agency and its certified law enforcement prescription drug diversion investigators until a determination is made by the department to allow continued access.

(1) The identification credentials assigned by the department; and

(2) The case number of the investigation.

(j)(1) A qualified law enforcement agency shall submit to the department an annual report of the data accessed by all certified law enforcement prescription drug diversion investigators in the qualified law enforcement agency, including without limitation:

(2) The department shall:

(A) Create a verification form for use under subdivision (j)(1) of this section; and

(B) Make the verification form available annually to the qualified law enforcement agency.

History. Acts 2011, No. 304, § 1; 2015, No. 901, § 2; 2015, No. 1208, §§ 3, 4; 2017, No. 820, § 1; 2019, No. 910, § 4952.

Amendments. The 2015 amendment by No. 901 added (i) and (j).

The 2015 amendment by No. 1208 inserted designation (g)(1); added (g)(2); inserted designation (h)(1); and added (h)(2).

The 2017 amendment redesignated former (d) as (d)(1); added “Except as required in subdivision (d)(2) of this section” in (d)(1); and added (d)(2) and (d)(3).

The 2019 amendment substituted “Secretary of the Department of Health” for “Director of the Department of Health” in (d)(2)(D).

20-7-605. Prescription Drug Monitoring Program Advisory Committee — Creation — Members.

1. The Prescription Drug Monitoring Program Advisory Committee shall be created by the State Board of Health upon the Department of Health’s procuring adequate funding to establish the Prescription Drug Monitoring Program.
2. The mission of the committee is to consult with and advise the department on matters related to the establishment, maintenance, operation, and evaluation of the Prescription Drug Monitoring Program.
3. The committee shall consist of:
   1. One (1) representative designated by each of the following organizations:
      1. The Arkansas Academy of Physician Assistants, Inc.;
      2. The Arkansas Association of Chiefs of Police;
      3. The Arkansas Drug Director;
      4. The Arkansas Medical Society, Inc.;
      5. The Arkansas Nurses Association;
      6. The Arkansas Optometric Association, Inc.;
      7. The Arkansas Osteopathic Medical Association;
      8. The Arkansas Pharmacist's Association;
      9. The Arkansas Podiatric Medical Association, Inc.;
      10. The Arkansas Prosecuting Attorneys Association;
      11. The Arkansas Sheriffs' Association;
      12. The Arkansas State Dental Association;
      13. The Arkansas Veterinary Medical Association;
      14. The State Board of Health; and
      15. The Arkansas Public Defender Commission;
   2. One (1) mental health provider or certified drug and alcohol counselor;
   3. One (1) consumer appointed by the Governor;
   4. The Chair of the Arkansas State Medical Board or his or her designee who is also a member of the Arkansas State Medical Board; and
   5. The President of the Arkansas State Board of Dental Examiners or his or her designee who is also a member of the Arkansas State Board of Dental Examiners.

History. Acts 2011, No. 304, § 1; 2017, No. 820, § 4.

A.C.R.C. Notes. It is unclear how the individual in (c)(2) is to be appointed.

Amendments. The 2017 amendment added (c)(4) and (c)(5).

20-7-606. Confidentiality.

1. Prescription information submitted to the Department of Health under this subchapter is confidential and not subject to the Freedom of Information Act of 1967, § 25-19-101 et seq.
2. 1. The controlled substances database created in this subchapter and all information contained in the controlled substances database and any records maintained by the Department of Health or by an entity contracting with the Department of Health that is submitted to, maintained, or stored as a part of the controlled substances database is privileged and confidential, is not a public record, and is not subject to subpoena or discovery in a civil proceeding.
   2. Information in the controlled substances database may be accessed by:
      1. A certified law enforcement officer pursuant to a criminal investigation but only after the law enforcement officer obtains a search warrant signed by a judge that demonstrates probable cause to believe that a violation of federal or state criminal law has occurred, that specified information contained in the database would assist in the investigation of the crime, and that the specified information should be released to the certified law enforcement officer;
      2. A regulatory body engaged in the supervision of activities of licensing or regulatory boards of practitioners authorized to prescribe or dispense controlled substances;
      3. A person or entity investigating a case involving breaches of privacy involving the database or its records;
      4. A certified law enforcement prescription drug diversion investigator of a qualified law enforcement agency;
      5. A practitioner within the Arkansas Medicaid prescription drug program;
      6. The Department of Human Services or the Crimes Against Children Division if:
         1. The purpose of the database access is related to an investigation under the Child Maltreatment Act, § 12-18-101 et seq., and not pursuant to a criminal investigation by a certified law enforcement officer; and
         2. The Department of Human Services has obtained a circuit court order to access the database under § 12-18-622; or
      7. The Office of Medicaid Inspector General for review and investigation of fraud, waste, and abuse within the Arkansas Medicaid prescription drug program if access is limited to beneficiaries of the Arkansas Medicaid prescription drug program.
3. This section does not apply to information, documents, or records created or maintained in the regular course of business of a pharmacy, a medical, dental, optometric, or veterinary practitioner, or another entity covered by this subchapter, and all information, documents, or records otherwise available from original sources are not immune from discovery or use in a civil proceeding merely because the information contained in the records was reported to the controlled substances database under this subchapter.
4. The Department of Health shall establish and enforce policies and procedures to ensure that the privacy and confidentiality of patients are maintained and that patient information collected, recorded, transmitted, and stored is protected and not disclosed to persons except as listed in § 20-7-607.
5. The Prescription Drug Monitoring Program shall establish and maintain a process for verifying the credentials and authorizing the use of prescription information by individuals and agencies listed in § 20-7-607.

History. Acts 2011, No. 304, § 1; 2013, No. 1090, § 2; 2015, No. 901, § 3; 2015, No. 1161, § 5; 2017, No. 46, § 2; 2019, No. 141, § 1.

Amendments. The 2013 amendment added (b)(2)(D).

The 2015 amendment by No. 901 inserted (b)(2)(D) and redesignated former (b)(2)(D) as (b)(2)(E).

The 2015 amendment by No. 1161, in (b)(2)(D)(ii) [now (b)(2)(F)(ii)], inserted “circuit” preceding “court” and substituted “12-18-622” for “12-18-604”.

The 2017 amendment inserted present (b)(2)(E); and redesignated former (b)(2)(E) as (b)(2)(F).

The 2019 amendment added (b)(2)(G).

20-7-607. Providing prescription monitoring information.

1. 1. 1. 1. The Department of Health shall review the Prescription Drug Monitoring Program information, including without limitation a review to identify information that appears to indicate whether a person is obtaining prescriptions in a manner that may represent misuse or abuse of controlled substances based on prescribing criteria determined by the Secretary of the Department of Health upon consultation with the Prescription Drug Monitoring Program Advisory Committee.
         2. The prescribing criteria shall be posted on the website of the department and be available in print upon request.
      2. If the information appears to indicate misuse or abuse may have occurred, the department shall notify the practitioners and dispensers who have prescribed or dispensed in the following manner:
         1. The department shall provide quarterly reports to the individual practitioners and dispensers; and
         2. If after twelve (12) months of providing quarterly reports to the practitioners and dispensers, the information appears to indicate misuse or abuse may be continuing, the department shall send a report to the licensing boards of the practitioner or dispenser who prescribed or dispensed the prescription.
      3. If information of misuse or abuse is identified, the department shall notify the practitioners and dispensers who prescribed or dispensed the prescriptions and the United States Diversion Control Division of the United States Drug Enforcement Administration.
      4. On or before January 1, 2019, the department shall contract with a vendor to make the program interactive and to provide same-day reporting in real time, if funding and technology are available.
   2. 1. The department may review the program information, including without limitation a review to identify information that appears to indicate whether a prescriber or dispenser may be prescribing or dispensing prescriptions in a manner that may represent misuse or abuse of controlled substances.
      2. If information of misuse or abuse is identified, the department may notify the professional licensing board of the prescriber or dispenser only after the relevant professional licensing board has provided the department with the parameters for triggering a notification from the department to the professional licensing board.
2. The department shall provide information in the program upon request and at no cost only to the following persons:
   1. 1. A person authorized to prescribe or dispense controlled substances for the purpose of providing medical or pharmaceutical care for his or her patients or for reviewing information regarding prescriptions that are recorded as having been issued or dispensed by the requester.
      2. An agent or employee of the prescriber or dispenser to whom the prescriber or dispenser has delegated the task of assessing the data described in this subsection, but only if the agent or employee has been granted access by a delegate account;
   2. A patient who requests his or her own prescription monitoring information;
   3. A parent or legal guardian of a minor child who requests the minor child's program information;
   4. 1. A designated representative of a professional licensing board of the professions of the healing arts representing healthcare disciplines whose licensees are prescribers pursuant to an investigation of a specific individual, entity, or business licensed or permitted by the licensing board.
      2. Except as permitted by subdivision (a)(2) of this section, the department shall provide information under subdivision (b)(4)(A) of this section only if the requesting licensing board states in writing that the information is necessary for an investigation;
   5. The State Medical Examiner as authorized by law to investigate causes of deaths for cases under investigation pursuant to his or her official duties and responsibilities;
   6. Local, state, and federal law enforcement or prosecutorial officials engaged in the administration, investigation, or enforcement of the laws governing controlled substances required to be submitted under this subchapter pursuant to the agency's official duties and responsibilities; and
   7. Personnel of the department for purposes of administration and enforcement of this subchapter.
3. Information collected under this subchapter shall be maintained for three (3) years.
4. The department may provide patient, prescriber, or dispenser information to public or private entities for statistical, research, or educational purposes after encrypting or removing any patient's name, street name and number, patient identification number, month and day of birth, and prescriber or dispenser information that could be used to identify individual patients or persons who received prescriptions.
5. The department may provide information in the program to insurance carriers for the purpose of verifying prescriber or dispenser registration for individuals that are part of the health plan's network of providers.

History. Acts 2011, No. 304, § 1; 2015, No. 901, § 4; 2015, No. 1208, § 1; 2017, No. 688, §§ 1, 2; 2017, No. 820, § 2; 2019, No. 910, § 4953.

Amendments. The 2015 amendment by No. 901 added “and the Office of Diversion Control of the United States Drug Enforcement Administration” at the end of (a)(2) [now (a)(1)(C)].

The 2015 amendment by No. 1208 redesignated former (a)(1) as (a)(1)(A) and former (a)(2) as (a)(1)(B); added present (a)(2); inserted designation (b)(1)(A); and added (b)(1)(B).

The 2017 amendment by No. 688, in (d), inserted “patient, prescriber, or dispenser”, substituted “any patient's” for “the patient's”, inserted “or dispenser”, and deleted “from dispensers, or both” following “prescriptions” at the end; and added (e).

The 2017 amendment by No. 820 redesignated former (a)(1)(A) as (a)(1)(A)(i); in (a)(1)(A)(i), substituted “shall” for “may”, substituted “is” for “may be”, and added “based on prescribing criteria determined by the Director of the Department of Health upon consultation with the Prescription Drug Monitoring Program Advisory Committee”; added (a)(1)(A)(ii); inserted present (a)(1)(B); redesignated former (a)(1)(B) as (a)(1)(C); and added (a)(1)(D).

The 2019 amendment substituted “Secretary of the Department of Health” for “Director of the Department of Health” in (a)(1)(A)(i).

20-7-608. Information exchange with other prescription drug monitoring programs.

1. The Department of Health may provide prescription monitoring information to federal prescription drug monitoring programs or other states' prescription drug monitoring programs, and the information may be used by those programs consistent with this subchapter.
2. The department may request and receive prescription monitoring information from federal prescription drug monitoring programs or other states' prescription drug monitoring programs and may use the information under this subchapter.
3. The department may develop the capability to transmit information to other prescription drug monitoring programs and receive information from other prescription drug monitoring programs employing the standards of exchangeability.
4. The department may enter into written agreements with federal prescription drug monitoring programs or other states' prescription drug monitoring programs for the purpose of describing the terms and conditions for sharing prescription information under this subchapter.

History. Acts 2011, No. 304, § 1; 2019, No. 605, § 1.

Amendments. The 2019 amendment inserted “federal prescription drug monitoring programs or” in (a), (b), and (d).

20-7-609. Authority to contract.

1. The Department of Health may contract with another agency of this state or with a private vendor, as necessary, to ensure the effective operation of the Prescription Drug Monitoring Program.
2. A contractor shall be bound to comply with the provisions regarding confidentiality of prescription information as outlined in this subchapter and shall be subject to the penalties specified in this subchapter for unlawful acts.

History. Acts 2011, No. 304, § 1.

20-7-610. Authority to seek funding.

1. The Department of Health may make application for, receive, and administer grant funding from public or private sources for the development, implementation, or enhancement of the Prescription Drug Monitoring Program.
2. A fee shall not be levied against practitioners for the purpose of funding or complying with the Prescription Drug Monitoring Program.

History. Acts 2011, No. 304, § 1.

20-7-611. Unlawful acts and penalties.

1. 1. It is unlawful for a dispenser to purposely fail to submit prescription monitoring information as required under this subchapter.
   2. A violation of subdivision (a)(1) of this section is a Class B misdemeanor.
2. 1. It is unlawful for a dispenser to purposely submit fraudulent prescription information.
   2. A violation of subdivision (b)(1) of this section is a Class D felony.
3. 1. It is unlawful for a person authorized to receive prescription monitoring information to purposely disclose the information in violation of this subchapter.
   2. A violation of subdivision (c)(1) of this section is a Class C felony.
4. 1. It is unlawful for a person authorized to receive prescription drug monitoring program information to use such information in a manner or for a purpose in violation of this subchapter.
   2. A violation of subdivision (d)(1) of this section is a Class C felony.
5. 1. It is unlawful for a person to knowingly obtain, use, or disclose or attempt to obtain, use, or disclose information by fraud or deceit from the Prescription Drug Monitoring Program or from a person authorized to receive information from the Prescription Drug Monitoring Program under this subchapter.
   2. A violation of subdivision (e)(1) of this section is a Class C felony.
6. In addition to the criminal penalties provided in this section, a dispenser or practitioner who uses or discloses confidential information received from the Prescription Drug Monitoring Program in a manner or for a purpose in violation of this subchapter may be subject to disciplinary action by the dispenser's or practitioner's licensing board.
7. In addition to the criminal penalties provided in this section, a law enforcement officer who uses or discloses confidential information received from the Prescription Drug Monitoring Program in a manner or for a purpose in violation of this subchapter may be subject to disciplinary action by the law enforcement officer's agency or department.
8. This subchapter does not limit a person whose privacy has been compromised unlawfully under this section from bringing a civil action to address the breach of privacy or to recover all damages to which the person may be entitled per violation, including attorney's fees and costs.
9. A practitioner who purposely fails to access the Prescription Drug Monitoring Program as required by § 20-7-604(d) is subject to disciplinary action by the licensing board of the practitioner.

History. Acts 2011, No. 304, § 1; 2017, No. 820, § 3.

Amendments. The 2017 amendment added (i).

20-7-612. Privacy rights protected.

This subchapter does not give authority to any person, agency, corporation, or other legal entity to invade the privacy of any citizen as defined by the General Assembly, the courts, or the United States Constitution or the Arkansas Constitution other than to the extent provided in this subchapter.

History. Acts 2011, No. 304, § 1.

20-7-613. Rules.

The State Board of Health shall adopt rules to implement this subchapter.

History. Acts 2011, No. 304, § 1.

20-7-614. Effective date.

1. The Prescription Drug Monitoring Program shall become operational March 1, 2013, if full funding is available under § 20-7-610.
2. The Secretary of the Department of Health may suspend operation of the program if adequate funding under § 20-7-610 ceases.

History. Acts 2011, No. 304, § 1; 2019, No. 910, § 4954.

Amendments. The 2019 amendment substituted “Secretary of the Department of Health” for “Director of the Department of Health” in (b).

20-7-615. Prescriber with a prescription drug violation.

1. A prescriber who has been found by his or her licensing board to be in violation of a rule or law involving prescription drugs shall be required by the appropriate licensing board to register with the Prescription Drug Monitoring Program and access patient information before writing a prescription for an opioid.
2. The licensing board, in its discretion, may remove this requirement after a period of time if the licensing board deems removal of the requirement appropriate.

History. Acts 2015, No. 1208, § 5.

Subchapter 7 — Combating Prescription Drug Abuse Act

20-7-701. Title.

This subchapter shall be known and may be cited as the “Combating Prescription Drug Abuse Act”.

History. Acts 2015, No. 1208, § 6.

20-7-702. Definitions.

As used in this subchapter:

1. “Chronic nonmalignant pain” means pain requiring more than three (3) consecutive months of prescriptions for:
   1. An opioid that is written for more than the equivalent of ninety (90) tablets, each containing five milligrams (5 mg) of hydrocodone;
   2. A morphine equivalent dose of more than fifteen milligrams (15 mg) per day; or
   3. In the specific case of tramadol, an average dose equivalent of two hundred milligrams (200 mg) or greater per day;
2. “Hospital” means a healthcare facility licensed as a hospital by the State Board of Health under § 20-9-213;
3. “Opioid” means a drug or medication that relieves pain, including without limitation:
   1. Codeine;
   2. Fentanyl;
   3. Heroin;
   4. Hydrocodone;
   5. Morphine; and
   6. Oxycodone; and
4. “Prescriber” means a practitioner or other authorized person who prescribes a Schedule II, III, IV, or V controlled substance.

History. Acts 2015, No. 1208, § 6; 2017, No. 72, § 1.

Amendments. The 2017 amendment substituted “an average dose equivalent of two hundred milligrams (200 mg) or greater per day” for “a dose of fifty milligrams (50 mg) or one hundred twenty (120) tablets” in (1)(C).

20-7-703. Opioid prescribing guidelines for emergency department.

1. A hospital with an emergency department shall adopt guidelines concerning opioid prescribing in the emergency department.
2. The guidelines shall be drafted jointly by the emergency department physicians and medical staff and approved by the governing body of the hospital.
3. The guidelines shall address, at a minimum:
   1. Treatment of chronic nonmalignant pain and acute pain;
   2. Limits on amounts or duration of opioid prescriptions; and
   3. Identification of situations where opioid prescriptions should be discouraged or prohibited.
4. The guidelines shall not be construed as establishing a standard of care.

History. Acts 2015, No. 1208, § 6.

20-7-704. Prescriber education.

1. 1. Within the first two (2) years of being granted a license in the state, a prescriber shall obtain a minimum of two (2) hours of prescribing education approved by the appropriate licensing board.
   2. The education approved by the appropriate licensing board under subdivision (a)(1) of this section shall include:
      1. Options for online and in-person programs; and
      2. Information on prescribing rules, regulations, and laws that apply to individuals who are licensed in the state.
2. This section shall apply to all prescribers licensed after December 31, 2015.

History. Acts 2015, No. 1208, § 6.

20-7-705. Licensing board rules.

1. A licensing board that licenses individuals with prescriptive authority shall adopt rules that are at least as stringent as the rules of the Arkansas State Medical Board concerning use of narcotics for the treatment of pain not associated with malignant or terminal illness.
2. A licensing board that licenses individuals who are authorized to prescribe opioids for treatment of chronic nonmalignant pain shall promulgate rules that contain, at a minimum, the requirements of § 20-7-707.

History. Acts 2015, No. 1208, § 6.

20-7-706. Patient evaluation.

A patient who is being treated with controlled substances for chronic nonmalignant pain shall be evaluated at least one (1) time every six (6) months by a physician who is licensed by the Arkansas State Medical Board.

History. Acts 2015, No. 1208, § 6.

20-7-707. Prescriber requirements.

1. For a patient with chronic nonmalignant pain, a prescriber, at a minimum and in addition to any additional requirements of the appropriate licensing board, shall:
   1. Check the prescriptive history of the patient on the Prescription Drug Monitoring Program at least every six (6) months; and
   2. Have a signed pain contract with the patient that states, at a minimum, the expectations of the prescriber for the behavior of the patient which may include:
      1. A requirement for random urine drug screenings to help ensure that the patient is abiding by the requirements of the contract; and
      2. A requirement for random pill counts to ensure compliance with the prescription.
2. The requirements of this section shall not apply to a patient:
   1. Whose pain medications are being prescribed for a malignant condition;
   2. With a terminal condition;
   3. Who is a resident of a licensed healthcare facility;
   4. Who is enrolled in a hospice program; or
   5. Who is in an inpatient or outpatient palliative care program.

History. Acts 2015, No. 1208, § 6.

20-7-708. Immunity.

A prescriber or licensed healthcare facility that in good faith reports a suspected drug diversion is immune from civil or criminal liability and disciplinary action by the appropriate licensing board.

History. Acts 2015, No. 1208, § 6.

Subchapter 1 — Health Services Permit Agency

A.C.R.C. Notes. References to “this subchapter” in §§ 20-8-101 — 20-8-110 may not apply to §§ 20-8-111 — 20-8-113, which were enacted subsequently.

Publisher's Notes. Former subchapter 1 of this chapter, concerning state health planning and development, was partially repealed by Acts 1987, No. 593, § 10, which repealed former §§ 20-8-101 — 20-8-103 and 20-8-114. The remainder of the subchapter, §§ 20-8-104 — 20-8-113, was repealed by Acts 1987, No. 593, § 9, as amended by Acts 1987 (1st Ex. Sess.), No. 40, § 11. The former subchapter was derived from the following sources:

20-8-101. Acts 1975, No. 558, §§ 1, 2; 1981, No. 808, § 1; A.S.A. 1947, §§ 82-2307, 82-2308.

20-8-102. Acts 1975, No. 558, § 6; 1981, No. 808, § 4; 1985, No. 857, § 2; 1985, No. 948, § 2; A.S.A. 1947, § 82-2312.

20-8-103. Acts 1975, No. 558, § 3; 1981, No. 808, § 2; 1983, No. 131, §§ 1-3, 5; 1983, No. 135, §§ 1-3, 5; A.S.A. 1947, §§ 6-623 — 6-626, 82-2309.

20-8-104. Acts 1975, No. 558, § 5; 1981, No. 808, § 3; A.S.A. 1947, § 82-2311.

20-8-105. Acts 1975, No. 558, § 5; 1981, No. 808, § 3; A.S.A. 1947, § 82-2311.

20-8-106. Acts 1975, No. 558, § 5; 1981, No. 808, § 3; A.S.A. 1947, § 82-2311.

20-8-107. Acts 1975, No. 558, § 5; 1981, No. 808, § 3; A.S.A. 1947, § 82-2311.

20-8-108. Acts 1975, No. 558, § 5; 1981, No. 808, § 3; A.S.A. 1947, § 82-2311.

20-8-109. Acts 1975, No. 558, § 5; 1981, No. 808, § 3; 1985, No. 857, § 1; 1985, No. 948, § 1; A.S.A. 1947, § 82-2311.

20-8-110. Acts 1975, No. 558, § 5; 1981, No. 808, § 3; 1985, No. 857, § 1; 1985, No. 948, § 1; A.S.A. 1947, § 82-2311.

20-8-111. Acts 1975, No. 558, § 5; 1981, No. 808, § 3; 1985, No. 857, § 1; 1985, No. 948, § 1; A.S.A. 1947, § 82-2311.

20-8-112. Acts 1975, No. 558, § 5; 1981, No. 808, § 3; 1985, No. 857, § 1; 1985, No. 948, § 1; A.S.A. 1947, § 82-2311.

20-8-113. Acts 1975, No. 558, § 5; 1981, No. 808, § 3; A.S.A. 1947, § 82-2311.

20-8-114. Acts 1977, No. 831, §§ 1-3; A.S.A. 1947, §§ 82-2314 — 82-2316.

Effective Dates. Acts 1987, No. 593, § 13: Apr. 4, 1987. Emergency clause provided: “It is hereby found and determined by the General Assembly that there is an immediate and urgent need to effect revisions in the health planning system of the State, health planning has a direct impact on the public health, welfare and safety; that an emergency is hereby declared to exist, and this Act is declared to be necessary for the preservation for the public peace, health and safety and shall become effective from and after its passage and approval.”

Acts 1987 (1st Ex. Sess.), No. 40, § 15: June 19, 1987. Emergency clause provided: “It is hereby found and determined by the General Assembly that Act 593 of 1987 contained technical errors and omissions which, if uncorrected, will result in the loss of federal dollars in assisting the elderly and needy population of this state with their health care needs; that an effective health planning system is needed in this state; that health planning has a direct impact on the public health, welfare and safety; that an emergency is hereby declared to exist, and this Act is declared to be necessary for the preservation for the public peace, health and safety and shall become effective from and after its passage and approval.”

Acts 1989, No. 107, § 7: Feb. 20, 1989. Emergency clause provided: “It is hereby found and determined by the General Assembly that the state does not have a statewide clearing house for health data; that the establishment of such a clearing house is essential to adequately respond to the health needs of the citizens of the state; that this Act creates a statewide health data clearing house; and that the collection of health data should begin immediately. Therefore, an emergency is hereby declared to exist and this Act being necessary for the immediate preservation of the public peace, health and safety shall be in full force and effect from and after its passage and approval.”

Acts 1989, No. 533, § 4: Mar. 14, 1989. Emergency clause provided: “It is hereby found and determined by the Seventy-Seventh General Assembly of the State of Arkansas that there is an immediate and urgent need to effect revisions in the health planning system of the state; that there are no promulgated regulations and there has been confusion regarding the issuance of permits for approval required for certain services, and that care to some patients has been interrupted. Therefore, an emergency is hereby declared to exist and this Act being immediately necessary for the preservation for the public peace, health, and safety, shall be in full force and effect from and after its passage and approval.”

Acts 1991, No. 623, § 6: Mar. 19, 1991. Emergency clause provided: “It is hereby found and determined by the Seventy-Eighth General Assembly that residential care facilities are now under the jurisdiction of the Health Service Commission; that representation on the commission by those covered by the commission is fundamental in a democratic society; that the immediate appointment of a representative on such commission is necessary to preserve the rights of those facilities being regulated by the commission. Therefore, an emergency is hereby declared to exist and this act being necessary for the immediate preservation of the public peace, health and safety shall be in full force and effect upon passage and approval.”

Acts 1993, No. 821, § 13: July 1, 1993. Emergency clause provided: “It is hereby found and determined by the Seventy-Ninth General Assembly, that the Constitution of the State of Arkansas prohibits the appropriation of funds for more than a two (2) year period; that the effectiveness of this Act on July 1, 1993 is essential to the operation of the agency for which the appropriations in this Act are provided, and that in the event of an extension of the Regular Session, the delay in the effective date of this Act beyond July 1, 1993 could work irreparable harm upon the proper administration and provision of essential governmental programs. Therefore, an emergency is hereby declared to exist and this Act being necessary for the immediate preservation of the public peace, health and safety shall be in full force and effect from and after July 1, 1993.”

Acts 1995, No. 77, § 13: July 1, 1995. Emergency clause provided: “It is hereby found and determined by the Eightieth General Assembly, that the Constitution of the State of Arkansas prohibits the appropriation of funds for more than a two (2) year period; that the effectiveness of this Act on July 1, 1995 is essential to the operation of the agency for which the appropriations in this Act are provided, and that in the event of an extension of the Regular Session, the delay in the effective date of this Act beyond July 1, 1995 could work irreparable harm upon the proper administration and provision of essential governmental programs. Therefore, an emergency is hereby declared to exist and this Act being necessary for the immediate preservation of the public peace, health and safety shall be in full force and effect from and after July 1, 1995.”

Acts 1997, No. 179, § 38: Feb. 17, 1997. Emergency clause provided: “It is hereby found and determined by the General Assembly that Act 10 of the First Extraordinary Session of 1995 abolished the Joint Interim Committee on Public Health, Welfare, and Labor and in its place established the House Interim Committee and Senate Interim Committee on Public Health, Welfare, and Labor; that various sections of the Arkansas Code refer to the Joint Interim Committee on Public Health, Welfare, and Labor and should be corrected to refer to the House and Senate Interim Committees on Public Health, Welfare, and Labor; that this act so provides; and that this act should go into effect immediately in order to make the laws compatible as soon as possible. Therefore, an emergency is declared to exist and this act being immediately necessary for the preservation of the public peace, health and safety shall become effective on the date of its approval by the Governor. If the bill is neither approved nor vetoed by the Governer, it shall become effective on the expiration of the period of time during which the Governor may veto the bill. If the bill is vetoed by the Governor and the veto is overridden, it shall become effective on the date the last house overrides the veto.”

Acts 1997, No. 250, § 258: Feb. 24, 1997. Emergency clause provided: “It is hereby found and determined by the General Assembly that Act 1211 of 1995 established the procedure for all state boards and commissions to follow regarding reimbursement of expenses and stipends for board members; that this act amends various sections of the Arkansas Code which are in conflict with the Act 1211 of 1995; and that until this cleanup act becomes effective conflicting laws will exist. Therefore an emergency is declared to exist and this act being immediately necessary for the preservation of the public peace, health and safety shall become effective on the date of its approval by the Governor. If the bill is neither approved nor vetoed by the Governer, it shall become effective on the expiration of the period of time during which the Governor may veto the bill. If the bill is vetoed by the Governor and the veto is overridden, it shall become effective on the date the last house overrides the veto.”

Acts 1997, No. 1025, § 6: Apr. 2, 1997. Emergency clause provided: “It is hereby found and determined by the General Assembly that this act excludes certain transitional pediatric rehabilitation facilities from the permit of approval process; and that this act is immediately necessary to allow such facilities to proceed without delay. Therefore, an emergency is declared to exist and this act being immediately necessary for the preservation of the public peace, health and safety shall become effective on the date of its approval by the Governor. If the bill is neither approved nor vetoed by the Governor, it shall become effective on the expiration of the period of time during which the Governor may veto the bill. If the bill is vetoed by the Governor and the veto is overridden, it shall become effective on the date the last house overrides the veto.”

Acts 2019, No. 910, § 6346(b): July 1, 2019. Emergency clause provided: “It is found and determined by the General Assembly of the State of Arkansas that this act revises the duties of certain state entities; that this act establishes new departments of the state; that these revisions impact the expenses and operations of state government; and that the sections of this act other than the two uncodified sections of this act preceding the emergency clause titled ‘Funding and classification of cabinet-level department secretaries’ and ‘Transformation and Efficiencies Act transition team’ should become effective at the beginning of the fiscal year to allow for implementation of the new provisions at the beginning of the fiscal year. Therefore, an emergency is declared to exist, and Sections 1 through 6343 of this act being necessary for the preservation of the public peace, health, and safety shall become effective on July 1, 2019”.

20-8-101. Definitions.

As used in this subchapter:

1. [Repealed.]
2. “Category of services” or “health services” means home healthcare services as defined by § 20-10-801;
3. [Repealed.]
4. “Conversion of services” means an alteration of the category of services offered by a health facility;
5. [Repealed.]
6. 1. “Health facility” means a long-term care facility as defined by § 20-10-101 or a home healthcare services agency as defined by § 20-10-801.
   2. “Health facility” shall not mean and nothing in this subchapter shall be deemed to require a permit of approval for or to otherwise regulate in any manner the licensure of:
      1. A hospital as defined by and licensed pursuant to § 20-9-201, except when a hospital seeks to add long-term care beds or to convert acute beds to long-term care beds or to add home health services pursuant to a letter of intent filed with the Department of Health after February 15, 1993, or to expand home health services pursuant to a letter of intent filed with the department after February 15, 1993;
      2. Offices of private physicians and surgeons;
      3. Outpatient surgery or imaging centers;
      4. Post-acute head injury retraining and residential care facilities or establishments operated by the United States Government or any agency thereof;
      5. Freestanding radiation therapy centers;
      6. Expansion, not to exceed fifteen (15) beds, of the twenty-five-bed nonprofit intermediate care facility for individuals with developmental disabilities that provides transitional rehabilitation for pediatric patients;
      7. Residences for four (4) or fewer individuals with developmental disabilities who receive support and services from nonprofit providers currently licensed by the Division of Developmental Disabilities Services;
      8. Any facility which is conducted by and for those who rely exclusively upon treatment by prayer for healing in accordance with the tenets or practices of any recognized religious denomination; or
      9. Any bed or facility used to provide care to delinquent juveniles committed into the care of the Division of Youth Services.
   3. “Health facility” shall not include offices of private physicians and surgeons, outpatient surgery or imaging centers, establishments operated by the United States Government or any of its agencies, freestanding radiation therapy centers, or any facility which is conducted by and for those who rely exclusively upon treatment by prayer alone for healing in accordance with the tenets or practices of any recognized religious denomination; and
7. “Transitional rehabilitation” means rehabilitation that typically results in discharge within twenty-four (24) months after the date of admission.

History. Acts 1987, No. 593, § 1; 1987 (1st Ex. Sess.), No. 40, §§ 1, 2; 1989, No. 422, §§ 1, 2, 7; 1993, No. 472, § 1; 1997, No. 1025, § 1; 2001, No. 1583, § 2; 2001, No. 1800, § 6; 2019, No. 389, §§ 7-9.

Amendments. The 2019 amendment repealed (1), (3), and (5).

20-8-102. Health Services Permit Commission — Creation — Members — Meetings.

1. There is established the Health Services Permit Commission.
2. The commission shall be composed of the following membership appointed by the Governor and confirmed by the Senate:
   1. A retired or practicing physician;
   2. A representative of the Department of Human Services or his or her designee;
   3. A member of the Arkansas Hospital Association, Inc.;
   4. A member of the Arkansas Health Care Association;
   5. A member of the Arkansas chapter of AARP, Inc.;
   6. A member of the HomeCare Association of Arkansas;
   7. A consumer knowledgeable in business health insurance;
   8. A member of the Arkansas Residential Assisted Living Association, Inc.; and
   9. A member of the Hospice and Palliative Care Association of Arkansas, Inc.
3. 1. All appointments shall be for four-year terms.
   2. No member shall be appointed to serve more than two (2) consecutive full terms.
4. The members shall serve without pay, but those members not employed by the State of Arkansas may receive expense reimbursement in accordance with § 25-16-901 et seq.
5. The commission shall meet at least quarterly and at such other times as necessary to carry out its duties under this subchapter. The commission shall elect one (1) of its members as chair, and by appropriate adoption of bylaws and rules, may provide for the time, place, and manner of calling its meetings.

History. Acts 1987, No. 593, § 2; 1987 (1st Ex. Sess.), No. 40, § 3; 1991, No. 623, § 1; 1997, No. 250, § 179; 2001, No. 632, § 1; 2001, No. 1800, § 7; Acts 2019, No. 957, § 1.

Amendments. The 2019 amendment inserted “retired or” in (b)(1); and added “or his or her designee” in (b)(2).

20-8-103. Health Services Permit Commission — Powers and duties.

1. The Health Services Permit Commission shall evaluate the availability and adequacy of health facilities and health services as they relate to long-term care facilities and home healthcare service agencies in this state.
2. The commission shall designate those locales or areas of the state in which, due to the requirements of the population or the geography of the area, the health service needs of the population are underserved.
3. The commission may specify, within locales or areas, categories of health services which are underserved or overserved due to the composition or requirements of the population or the geography of the area.
4. The commission shall develop policies and adopt criteria, including time limitations, to be utilized by the Health Services Permit Agency in the review of applications and the issuing of permits of approval for a long-term care facility or a home healthcare service agency as provided in this subchapter.
5. The commission may define certain underserved locales or areas or categories of services within underserved locales or areas to be exempt for specified periods of time from the permit-of-approval requirement.
6. The commission may set application fees for permit-of-approval applications to be charged and collected by the agency.
7. 1. Upon appeal by the applicant or an interested party, the commission shall conduct hearings on decisions by the agency within ninety (90) days of the agency decision. The commission shall render its final decision within fifteen (15) days of the close of the hearing. Failure of the commission to take final action within these time periods shall be considered a ratification of the agency decision and shall constitute the final decision of the commission from which an appeal to circuit court may be filed.
   2. Neither a competitor of a successful applicant for a permit of approval nor any other party shall have the right to appeal the commission's decision to grant a permit of approval.

History. Acts 1987, No. 593, § 3; 1987 (1st Ex. Sess.), No. 40, §§ 4, 5; 1989, No. 422, §§ 3-5; 2001, No. 1800, § 8.

20-8-104. Health Services Permit Agency — Powers and duties.

1. There is created and established the Health Services Permit Agency, which shall be under the supervision and control of the Department of Health.
2. The agency, under the administration of the department, shall possess and exercise such duties and powers as necessary to implement the policy and procedures adopted by the Health Services Permit Commission.
3. The agency, under the administration of the department, shall review all applications for permits of approval and approve or deny the application within ninety (90) days from the date the application is deemed complete and submitted for review.
4. The State of Arkansas shall not participate in the capital expenditures review program, otherwise known as the “1122 Program”, unless it becomes mandatory for continuation in federal programs authorized under Title V of the Social Security Act, 42 U.S.C. § 701 et seq., Title XIV of the Social Security Act, 42 U.S.C. § 1351 et seq., and Title XVII of the Social Security Act, 42 U.S.C. § 1391 et seq., for all states.
5. The agency, under the administration of the department, shall assist the commission in the performance of its duties under this subchapter.

History. Acts 1987, No. 593, § 4; 2001, No. 1800, § 9; 2019, No. 910, § 4955.

Amendments. The 2019 amendment, in (a), deleted “an independent agency” preceding “under” and substituted “Department of Health” for “Governor”; and inserted “under the administration of the Department of Health” in (b), (c), and (e).

20-8-105. Director.

1. There shall be a Director of the Health Services Permit Agency, who shall be the executive head of the Health Services Permit Agency.
2. The director shall be appointed by the Governor, subject to confirmation by the Senate, and shall serve at the pleasure of the Governor.
3. The director shall report to the Secretary of the Department of Health.

History. Acts 1987, No. 593, § 5; 2001, No. 1800, § 10; 2019, No. 910, § 4956.

Amendments. The 2019 amendment inserted designations (a) and (b); and added (c).

20-8-106. Health Services Program — Permits generally.

1. 1. A permit of approval shall not be required by the Health Services Permit Agency or the Health Services Permit Commission for any applicant to qualify for a Class B license, as provided in § 20-10-801 et seq., to operate a home healthcare services agency, if the home healthcare services agency was serving patients on or before June 30, 1988, and if the home healthcare services agency serves the residents of the county where the principal office is located.
   2. Nursing home applications under review by the Health Services Permit Agency on June 2, 1987, are considered under the provisions of this subchapter under updated standards on a county-by-county basis.
   3. 1. Beginning July 1, 2005, the Health Services Permit Agency may not accept applications for permits of approval for the construction of new residential care facilities.
      2. Applications for replacement of residential care facilities may not be accepted and processed after July 1, 2005.
      3. However, applications for replacement of residential care facilities shall be accepted for residential care facilities of sixteen (16) beds or fewer but only if the number of beds required for replacement is less than or equal to the number of beds for which the residential care facility was licensed before the application for replacement.
2. 1. 1. The alteration or renovation of a health facility having an associated capital expenditure of less than one million dollars ($1,000,000) for nursing homes and not resulting in additional bed capacity shall not require a permit of approval.
      2. However, the Health Services Permit Agency shall not allow hospital acute care beds to be converted to or allow their license classification to be changed to long-term care beds without going through the permit-of-approval process.
   2. Permits, legal title, and right of ownership may be transferred with the approval of the commission if the entity presently holding the permit, legal title, or right of ownership has tangible assets of at least two thousand five hundred dollars ($2,500) that will be transferred with the permit, legal title, or right of ownership.
   3. The application for the permit of approval shall include, but need not be limited to, such information as is necessary to determine:
      1. Whether the proposed project is needed or projected as being necessary to meet the needs of the locale or area in terms of the health care required for the population or geographic region;
      2. Whether the proposed project can be adequately staffed and operated when completed;
      3. Whether the proposed project is economically feasible; and
      4. Whether the project will foster cost containment through improved efficiency and productivity.
3. If the application is granted, the Health Services Permit Agency shall issue a permit of approval, if it finds that the proposed project meets the criteria for approval as set by the commission. If the application is denied, the Health Services Permit Agency shall send written notice of the denial to the applicant which sets forth the criteria that the proposed project failed to meet.
4. Any applicant or interested party seeking review of a final Health Services Permit Agency decision regarding permits of approval, movement of beds, or transfer of permits of approval shall file a written appeal for hearing before the commission on an approved form within thirty (30) days of the receipt of the Health Services Permit Agency decision.
5. Appeals to the commission shall be conducted in accordance with the Arkansas Administrative Procedure Act, § 25-15-201 et seq.

History. Acts 1987, No. 593, § 6; 1987 (1st Ex. Sess.), No. 40, § 6; 1989, No. 422, § 6; 1989, No. 533, § 1; 2001, No. 1800, § 11; 2005, No. 1669, § 1; 2009, No. 649, § 1; 2013, No. 1132, § 2.

A.C.R.C. Notes. Acts 1987 (1st Ex. Sess.), No. 40, § 8, provided: “Any hospital licensed by the Arkansas State Department of Health that applied to operate a home health agency under the provisions of Act 593 of 1987 before June 1, 1987, shall be exempt from the permit of approval requirement. Any agency, firm, corporation or organization that applied to operate a home health agency under the provisions of Act 593 of 1987 before June 1, 1987 must reapply to the Health Services Agency no later than June 30, 1987 to be reviewed and exempt from the moratorium contained in Section 6 of Act 593 of 1987 as amended herein.”

Acts 1987 (1st Ex. Sess.), No. 40, § 9, provided: “Any hospital desiring to operate a home health agency which is located in a municipality with a population of more than 10,000 but less than 11,000 in a county with a population of 26,000 or more according to the 1980 Federal decennial census, shall be exempt from the permit of approval requirement and the moratorium contained in Section 6 of Act 593 of 1987 as amended herein.”

Amendments. The 2009 amendment substituted “one million dollars ($1,000,000)” for “five hundred thousand dollars ($500,000)” in (b)(1)(A).

The 2013 amendment deleted (a)(1) and redesignated former (a)(2) through (a)(4) as present (a)(1) through (a)(3); in present (a)(1), substituted “A” for “No” and inserted “not”; and substituted “are” for “shall be” in (a)(2).

20-8-107. Expansion of facilities or services.

1. Unless otherwise provided in this subchapter, all health facilities seeking to add new beds or home health services or to expand existing bed capacity or home health services shall apply for a permit approving additional beds or services or expanded bed capacity or services pursuant to procedures and criteria promulgated by the Health Services Permit Commission.
2. The commission may authorize the Health Services Permit Agency to enjoin construction or expansion of existing facilities of any project commenced in violation of this subchapter through an action filed in the circuit court of the judicial district in which the project is located.
3. In no event shall the requirements of this subchapter apply to any facility licensed or approved as of March 1, 2003, by the Child Welfare Agency Review Board pursuant to the Child Welfare Agency Licensing Act, § 9-28-401 et seq., and as specifically exempted by § 9-28-407(a)(3).
4. Beginning July 1, 2005, the Health Services Permit Agency may not accept applications or requests for permits of approval to add new beds or to expand existing bed capacity of residential care facilities.

History. Acts 1987, No. 593, § 7; 1987 (1st Ex. Sess.), No. 40, § 7; 2003, No. 1285, § 2; 2005, No. 1669, § 2.

20-8-108. Fees and fines.

All fees and fines collected under this subchapter shall be deposited into the Miscellaneous Agencies Fund Account to be used exclusively for the maintenance and operation of the Health Services Permit Agency, including any agreements to reimburse the Department of Health for costs associated with the operation of the agency.

History. Acts 1987, No. 593, § 8; 1987 (1st Ex. Sess.), No. 40, § 10; 2001, No. 1800, § 12; 2019, No. 910, § 4957.

Amendments. The 2019 amendment added “including any agreements to reimburse the Department of Health for costs associated with the operation of the Health Services Permit Agency”.

20-8-109. Approval of new projects — Repeal of Acts 1975, No. 558, § 5 — Transfer of duties — Definition.

1. All projects requiring approval under the Certificate of Need Program as established by Acts 1975, No. 558, § 5 [repealed], except freestanding radiation therapy centers, shall not be instituted or commenced after April 4, 1987, except upon application for and receipt of approval from the Health Services Permit Agency utilizing the same criteria and procedures in existence before April 4, 1987.
2. As used in this section, “commence construction” means the approval of project financing or the actual movement onto the site of building materials and equipment by the principal contractor.
3. Two hundred ten (210) days after April 4, 1987, Acts 1975, No. 558, § 5, as amended, is repealed. On and after the two hundred eleventh day following April 4, 1987, all projects requiring approval under § 20-8-107 shall not be instituted or commenced except upon application for and receipt of a permit of approval as set forth in this subchapter, and, during this period of time, all duties and responsibilities of the State Health Planning and Development Agency and the Statewide Health Coordinating Council are transferred to the Health Services Permit Agency established under this subchapter. Any project not requiring approval under this subchapter, even though covered under Acts 1975, No. 558, § 5 [repealed], may be commenced after April 4, 1987.
4. 1. The Health Services Permit Agency shall process all applications or certificates of need for intermediate care facilities for individuals with intellectual or other developmental disabilities with fifteen (15) or fewer beds that were pending on April 4, 1987, and shall for a period of thirty (30) days after April 4, 1987, accept additional applications for such facilities.
   2. The applications shall be processed utilizing the criteria and procedures in existence before April 4, 1987, and in addition the Health Services Permit Agency shall consider as a primary factor the experience of each applicant in serving individuals with intellectual or other developmental disabilities.

History. Acts 1987, No. 593, § 9; 1987 (1st Ex. Sess.), No. 40, § 11; 2001, No. 1800, § 13; 2019, No. 1035, § 11.

Amendments. The 2019 amendment added the (d)(1) and (d)(2) designations; in (d)(1), deleted “the” preceding “individuals” and inserted “intellectual or other”; substituted “serving individuals with intellectual or other developmental disabilities” for “serving the developmentally disabled population” in (d)(2); and made a stylistic change.

20-8-110. Collection and dissemination of health data.

1. The Health Services Permit Agency shall act as a statewide health data clearinghouse for the acquisition and dissemination of data from healthcare providers, the Arkansas Medicaid Program, third-party payors, state agencies, and other appropriate sources in furtherance of this section.
2. All state agencies having information with regard to health matters shall make available to the Health Services Permit Agency such health data as is necessary for the Health Services Permit Commission to carry out its responsibilities.
3. All health facilities requiring a permit of approval by the state shall submit annually a report of utilization statistics as may be required by the Health Services Permit Agency.
4. The Insurance Commissioner shall require all third-party payors, including, but not limited to, licensed insurers, medical and hospital service corporations, health maintenance organizations, and self-funded employee health plans, to provide the commission with claims data for health matters.
5. State agencies which survey hospitals, home health agencies, outpatient surgery centers, or nursing homes for licensure or certification shall annually report to the Health Services Permit Agency on the surveys of the various facilities. The annual report shall list facilities by name with patient care citations and numbers of serious patient injuries per year by facility.
6. The Director of the Health Services Permit Agency shall be empowered to release data collected pursuant to this section, subject to the following limitations:
   1. Data released shall not include any information which could be used to identify any individual patient; and
   2. Data released shall not include any information which could be used to associate any of the data with any specific third-party payor.
7. The Secretary of the Department of Health shall prescribe such rules as may be necessary to carry out the purpose of this section.
8. 1. With the advice of the commission, the director shall compile and publish summaries of health data collected by the Health Services Permit Agency.
   2. 1. The director shall prepare an annual report of the Health Services Permit Agency's findings and submit the report to the secretary, the General Assembly, and the House Committee on Public Health, Welfare, and Labor and the Senate Committee on Public Health, Welfare, and Labor or appropriate subcommittees thereof.
      2. The Health Services Permit Agency shall provide assistance to the House Committee on Public Health, Welfare, and Labor and the Senate Committee on Public Health, Welfare, and Labor in the development of information necessary in the examination of healthcare issues.
9. 1. The Health Services Permit Agency may impose a fine on health facilities requiring a permit of approval for failure to timely submit reports of statistics as required by the Health Services Permit Agency.
   2. The Health Services Permit Agency may impose a fine of:
      1. Up to one hundred dollars ($100) for a report more than thirty (30) days late;
      2. Two hundred fifty dollars ($250) for a report more than sixty (60) days late; and
      3. Five hundred dollars ($500) for a report more than ninety (90) days late.

History. Acts 1989, No. 107, §§ 1-4; 1997, No. 179, § 23; 2001, No. 1800, § 14; 2005, No. 1271, §§ 1, 2; 2007, No. 827, § 149; 2007, No. 1589, §§ 1, 2; 2019, No. 315, § 1825; 2019, No. 910, §§ 4958, 4959.

A.C.R.C. Notes. Pursuant to Acts 2007, No. 827, § 240, the amendment of § 20-8-110 by Acts 2007, No. 1589, § 2 supersedes the amendment of § 20-8-110 by Acts 2007, No. 827, § 149.

Amendments. The 2019 amendment by No. 315 deleted “and regulations” following “rules” in (g).

The 2019 amendment by No. 910, in (g), substituted “Secretary of the Department of Health” for “director” and deleted “and regulations” following “rules”; and substituted “Secretary of the Department of Health” for “Governor” in (h)(2)(A).

20-8-111. Transfer of Developmental Disabilities Planning Council attributes to other agency.

The Governor may at any time transfer all personnel, appropriations, fund balances, and authorized positions, and the powers, duties, and personnel of the Developmental Disabilities Planning Council to any other designated agency of the state which meets the requirements of Pub. L. No. 101-496 [repealed].

History. Acts 1993, No. 821, § 6.

A.C.R.C. Notes. References to “this subchapter” in §§ 20-8-101 — 20-8-110 may not apply to this section, which was enacted subsequently.

This section may be superseded by § 20-8-112.

U.S. Code. Pub. L. No. 101-496, referred to in this section and codified as 42 U.S.C. § 6000 et seq., was repealed by Pub. L. No. 106-402 on October 30, 2000. For similar provisions, see 42 U.S.C. §§ 15001, 15002.

20-8-112. Additional transfer of Developmental Disabilities Planning Council attributes to other agency.

The Governor may at any time transfer all the powers, duties, personnel, appropriations, fund balances, and authorized positions of the Developmental Disabilities Planning Council to any other designated agency of the state which meets the requirements of Pub. L. No. 103-230 [repealed].

History. Acts 1995, No. 77, § 6; 1997, No. 58, § 8.

A.C.R.C. Notes. References to “this subchapter” in §§ 20-8-101 — 20-8-110 may not apply to this section which was enacted subsequently.

U.S. Code. Pub. L. No. 103-230, referred to in this section and codified as 42 U.S.C. § 6001 et seq., was repealed by Pub. L. No. 106-402 on October 30, 2000. For similar provisions, see 42 U.S.C. §§ 15001, 15002.

20-8-113. Findings.

The General Assembly finds and determines that:

1. The Division of Youth Services of the Department of Human Services is obligated by law to provide appropriate care to juveniles adjudicated delinquent and committed to the division's custody;
2. The division, pursuant to judicial decrees, assumes custody of delinquent juveniles with little or no notice;
3. The nature of the criminal conduct engaged in by the juvenile may create the necessity to segregate these juveniles within treatment facilities, thereby denying the division otherwise available beds;
4. The division must secure sufficient facilities for the care of delinquent juveniles in its custody;
5. The need for these facilities may vary substantially from the needs anticipated by the Department of Human Services or by the Health Services Permit Commission; and
6. No permit of approval should be required for facilities or beds contracted for or otherwise provided for delinquent youth committed to the custody of the division or the beds provided for delinquent youth counted against the authorized beds otherwise provided by a facility or organization with a permit of approval.

History. Acts 2001, No. 1583, § 1.

Subchapter 2 — Arkansas Spinal Cord Commission

Effective Dates. Acts 1975, No. 311, § 9: Mar. 4, 1975. Emergency clause provided: “It is hereby found and determined by the General Assembly that legislative findings and purposes set forth in Section 1 of this Act document the immediate need for the establishment of an adequate program to assist in the treatment and rehabilitation of persons suffering from congenital and acquired spinal cord dysfunctions, and that the immediate passage of this Act is necessary to enable the Governor to establish a State Spinal Cord Commission to immediately commence the development, implementation, and operation of a spinal cord treatment program in this State for deserving and qualified citizens of this State. Therefore, an emergency is hereby declared to exist, and this Act being necessary for the immediate preservation of the public peace, health, and safety, shall be in full force and effect from and after the date of its passage and approval.”

Acts 1977, No. 428, § 2: passed over Governor's veto, Mar. 15, 1977. Emergency clause provided: “It is hereby found and determined by the General Assembly that the State Spinal Cord Commission performs vital services benefiting spinal cord injured victims in this State; that the immediate reorganization of the said Commission is necessary to provide for a more efficient Commission, and that the immediate passage of this Act is necessary to accomplish such purpose. Therefore, an emergency is hereby declared to exist and this Act, being necessary for the immediate preservation of the public peace, health, and safety, shall be in full force and effect from and after its passage and approval.”

Acts 1997, No. 250, § 258: Feb. 24, 1997. Emergency clause provided: “It is hereby found and determined by the General Assembly that Act 1211 of 1995 established the procedure for all state boards and commissions to follow regarding reimbursement of expenses and stipends for board members; that this act amends various sections of the Arkansas Code which are in conflict with the Act 1211 of 1995; and that until this cleanup act becomes effective conflicting laws will exist. Therefore an emergency is declared to exist and this act being immediately necessary for the preservation of the public peace, health and safety shall become effective on the date of its approval by the Governor. If the bill is neither approved nor vetoed by the Governer it shall become effective on the expiration of the period of time during which the Governor may veto the bill. If the bill is vetoed by the Governor and the veto is overridden, it shall become effective on the date the last house overrides the veto.”

Acts 2019, No. 910, § 6346(b): July 1, 2019. Emergency clause provided: “It is found and determined by the General Assembly of the State of Arkansas that this act revises the duties of certain state entities; that this act establishes new departments of the state; that these revisions impact the expenses and operations of state government; and that the sections of this act other than the two uncodified sections of this act preceding the emergency clause titled ‘Funding and classification of cabinet-level department secretaries’ and ‘Transformation and Efficiencies Act transition team’ should become effective at the beginning of the fiscal year to allow for implementation of the new provisions at the beginning of the fiscal year. Therefore, an emergency is declared to exist, and Sections 1 through 6343 of this act being necessary for the preservation of the public peace, health, and safety shall become effective on July 1, 2019”.

20-8-201. Legislative intent.

1. It is declared and found that a major problem facing medicine and the public health and welfare is the absence of an adequate program to assist in the treatment and rehabilitation of persons with congenital or acquired spinal cord dysfunction.
2. 1. It has been found that no fewer than one thousand one hundred (1,100) Arkansas residents presently have spinal cord injury or damage, and it is estimated that at least one hundred twenty (120) Arkansans experience serious injury or congenital dysfunction of the spinal cord annually.
   2. Furthermore, it has been found that a fully coordinated approach to the early recognition, the emergency care and transportation, the definitive treatment and rehabilitation, and the long-term management direction and support of persons with congenital or acquired spinal cord dysfunction is presently lacking and yet is essential to guaranteeing persons with congenital or acquired spinal cord dysfunction the best possible opportunity to minimize mortality, morbidity, and permanent disability.
   3. It is further recognized that the enormous cost for medical services, hospitalization, and rehabilitative care of persons with congenital or acquired spinal cord dysfunction makes it extremely difficult, and often financially impossible, for persons of moderate or modest means to secure adequate medical and rehabilitative services, and in most cases, services are financially possible only by the very wealthy, if at all.
   4. Therefore, to guarantee the best possible opportunity for minimizing the mortality, morbidity, and permanent disability of persons due to spinal cord injury or dysfunction, it is essential that the state develop a program to:
      1. Provide for complete identification and visible integration of the numerous complex funding mechanisms which are applicable to the needs of a particular person at each overlapping stage of treatment and rehabilitation and provide financial assistance when necessary to fill a specific identified gap in funding a portion of the coordinated treatment and rehabilitation plan of a specified person when the person's own financial resources are insufficient to meet such requirements;
      2. Authorize the development and operation of an Arkansas spinal cord treatment center and system which will integrate present treatment and rehabilitative capabilities and develop additional service capabilities as necessary to guarantee the availability of continuously current and evolving new processes in state-of-the-art treatment and rehabilitative services to all Arkansans who have congenital or acquired spinal cord dysfunction; and
      3. Provide for full coordination of treatment and rehabilitation efforts from problem recognition through progressive rehabilitation and for as long as a need for these specialized services shall exist.

History. Acts 1975, No. 311, § 1; A.S.A. 1947, § 82-3301; Acts 2019, No. 389, § 10.

Amendments. The 2019 amendment substituted “with” for “suffering from” in (a); substituted “have” for “suffer from” in (b)(1); in (b)(2), substituted “persons with congenital or acquired spinal cord dysfunction” for “such persons” and for “these patients”; substituted “persons with congenital or acquired spinal cord dysfunction” for “spinal cord injured persons” in (b)(3); in (b)(4)(A), substituted “person” for “individual”, “person” for “patient”, and “person’s” for “patient’s”; and substituted “Arkansans who have congenital or acquired spinal cord dysfunction” for “spinal cord disabled Arkansans” in (b)(4)(B).

20-8-202. Creation — Members.

1. There is established the Arkansas Spinal Cord Commission, to consist of five (5) members to be appointed by the Governor from the state at large for terms of ten (10) years and confirmed by the Senate, as provided by law. The members of the commission shall be either spinal cord injured victims themselves, members of the immediate families of spinal cord injured victims, or persons with special knowledge of and experience with spinal cord injuries and dysfunctions who have demonstrated active involvement and interest in the fight against death and disability due to spinal cord injury and dysfunction.
2. Members of the commission shall serve until their successors are appointed and confirmed.
3. If a vacancy occurs on the commission due to death, resignation, or other cause, the vacancy shall be filled by appointment of the Governor of a person eligible for the initial appointment as set forth in this section, to serve for the remainder of the unexpired portion of the term of the member.
4. 1. The commission shall select a disbursing officer of funds appropriated to the commission. All expenditures shall be approved by the chair of the commission before their disbursement.
   2. The commission shall annually elect one (1) of its members as chair and one (1) of its members as vice chair, and other officers as the commission deems necessary.
5. Members of the commission shall serve without pay but shall be reimbursed from commission funds, if available, for reasonable and necessary expenses incurred in attending to commission business, in the same manner and in accordance with the same conditions, restrictions, and limitations as are applicable to employees of the state.
6. Members of the commission shall qualify by taking the oath of office as prescribed by law.
7. The commission shall meet at least one (1) time each calendar quarter and at such other times as may be designated by the commission's rules, or upon call by the chair or by the written request of any four (4) members.
8. 1. From time to time, the commission may create advisory committees as are deemed necessary to assist the commission in formulating policies, effectuating and reviewing operating procedures, and for such other purposes as the commission may deem appropriate.
   2. The members of the advisory committees shall serve without pay, but the commission may reimburse members of the advisory committees for expenses in accordance with § 25-16-901 et seq. if sufficient funds are available.

History. Acts 1975, No. 311, §§ 2, 3; 1977, No. 428, § 1; A.S.A. 1947, §§ 82-3302, 82-3303; Acts 1987, No. 263, §§ 1, 2; 1993, No. 1154, § 1; 1997, No. 250, § 180.

20-8-203. Powers and duties.

The Arkansas Spinal Cord Commission shall have the following functions, powers, and duties:

1. To identify and cooperate with existing agencies, organizations, and individuals offering services to the spinal cord injured or spina bifida patient for the establishment and integration of a statewide system of treatment, rehabilitation, counseling, and social services by means of entering into cooperative agreement with the agencies, organizations, and individuals. The programs shall be designed and administered to:
   1. Provide for coordinated and integrated development and continued review of a full treatment and rehabilitation plan for each qualified applicant patient;
   2. Identify all possible and existing funding sources for each type of service identified in the treatment plan for which a qualified patient may be eligible and assist the patient in obtaining funding assistance for which he or she is eligible from existing sources;
   3. Assess the patient's financial ability to pay for needed services identified in the treatment plan for which no other funding sources are available;
   4. Provide financial assistance for persons unable to pay for the services, including special equipment, without causing unjust and unusual hardship, including, but not limited to, a drastic lowering of the standard of living to the person or his or her immediate family;
   5. Identify service needs which cannot be adequately met by existing resources;
   6. Provide for increased accountability by documenting the full range of fiscal resources being invested from the various funding sources toward the achievement of each patient's service plan objectives; and
   7. Provide an annual report to the Secretary of the Department of Health, to the General Assembly, and to the public documenting areas of success, unresolved problems, and overall cost-benefit analyses of expenditures from the various sources;
2. 1. To develop or cause to be developed an Arkansas spinal cord treatment center and system to serve the entire state through the provision of such direct and indirect services as may be identified and documented as provided in subdivision (1) of this section.
   2. The center and system may provide such services as:
      1. Specialized emergency and acute care;
      2. Specialized emergency transfer services;
      3. Specialized diagnostic and prescriptive services;
      4. Specialized rehabilitative services;
      5. Family education and home care outreach services;
      6. Coordinated services;
      7. Continuing educational services for physicians and other health professionals and paraprofessionals who deal with the spinal cord patient; and
      8. Other services deemed necessary and appropriate by the commission.
   3. At such time as an Arkansas spinal cord treatment center is established, the commission shall serve as its board of directors and may either directly administer the operation of the center or may enter into contractual agreements with existing institutions for facilities, staffing, and administrative services or such other services as the commission deems appropriate.
   4. 1. Until an Arkansas spinal cord treatment center is established, or after a center is established, the commission may contract and pay for services provided by other institutions whenever the commission determines it to be in the best interest of a spinal cord injured person.
      2. It is the intent of this subchapter that the commission have broad discretion in providing or obtaining for spinal cord injured patients a complete level of services which the commission deems to be in the best interest of the patient, as set forth in this subchapter;
3. To work with all appropriate agencies, organizations, and individuals throughout the state to develop a fully integrated statewide network of coordinated services for spinal cord patients covering all needed services from the detection of spinal cord injuries or congenital conditions through the related phases of emergency care and transfer, acute and definitive care, and rehabilitative and follow-up care and to thus effect a measured reduction in spinal cord-related morbidity and mortality, long-term disability, and long-term maintenance system expenditures of public funds;
4. To provide special expert consultation and services to cooperating and participating agencies, institutions, and individuals, including appropriate elements of the emergency medical services system, on the emergency care and transportation of spinal cord injured persons as well as to other agencies, institutions, and individuals responsible for the delivery of professional medical and health sciences education and training necessary for providing appropriate progressive and evolving specialized programs of treatment of service to spinal cord injured and spina bifida patients;
5. To develop standards for determining eligibility for assistance to defray the cost of care and treatment of spinal cord patients under this program; and
6. To accept gifts, grants, and donations from private sources, from municipal and county governments, from the state, and from the United States Government to be used for the purposes of this subchapter to defray costs incurred by persons suffering from spinal cord disability who are unable to meet the total cost of treatment and rehabilitation and to promote the development of specialized service capability found to be needed but not available.

History. Acts 1975, No. 311, § 4; A.S.A. 1947, § 82-3304; Acts 2019, No. 910, § 4960.

Amendments. The 2019 amendment substituted “Secretary of the Department of Health” for “Governor” in (1)(G).

20-8-204. [Repealed.]

Publisher's Notes. This section, concerning the Fiscal Resource Advisory Committee, was repealed by Acts 1999, No. 1133, § 2. The section was derived from Acts 1975, No. 311, § 5; A.S.A. 1947, § 82-3305.

20-8-205. [Repealed.]

Publisher's Notes. This section, concerning disbursement of funds, was repealed by Acts 1987, No. 263, § 3. The section was derived from Acts 1975, No. 311, § 6; A.S.A. 1947, § 82-3306.

20-8-206. Central registry — Definition — Legislative intent.

1. 1. The Arkansas Spinal Cord Commission shall establish and maintain a central registry of spinal cord disabled persons. Every public and private health and social agency and attending physician shall report to the commission within five (5) calendar days after identification of any spinal cord disabled person. However, the consent of the individual shall be obtained before making this report, except that every spinal cord disease or injury resulting in permanent partial, permanent total, or total disability shall be reported to the commission immediately upon identification.
   2. The report shall contain the name, age, residence, and type of disability of the individual and such additional information as may be deemed necessary by the commission.
2. 1. Within fifteen (15) days of the report and identification of a spinal cord disabled person, the commission shall notify the spinal cord disabled person or the most immediate family members of their right to assistance from the state, the services available, and the eligibility requirements.
   2. The commission shall refer severely disabled persons to appropriate divisions, departments, and other state agencies to assure that maximum available rehabilitative services, if desired, are obtained by the spinal cord disabled person.
   3. All other agencies of the state shall cooperate with the commission to ensure that appropriate total rehabilitative and other services are available, as well as access to records and other information.
3. As used in this section, “spinal cord disabled” means any person who has a spinal cord disease or injury, congenital or acquired, which results in partial or total loss of motor or sensory functions and which results in temporary or permanent partial or total disability.
4. It is the intent of the General Assembly to ensure the referral of all spinal cord disabled persons to the commission by appropriate individuals or public and private agencies in order that all spinal cord disabled persons might obtain the appropriate total rehabilitative services rendered by existing state agencies, state departments, and other organizations and individuals.

History. Acts 1977, No. 170, §§ 1-4; 1977, No. 330, §§ 1-4; A.S.A. 1947, §§ 82-3307 — 82-3310; Acts 1993, No. 1154, § 2.

Subchapter 3 — Great Strides Grant Program

Publisher's Notes. Former subchapter 3 was repealed by Acts 1991, No. 343, § 8. The subchapter was derived from the following sources:

20-8-301. Acts 1979, No. 246, § 1; 1979, No. 679, § 1; A.S.A. 1947, § 82-4101.

20-8-302. Acts 1979, No. 246, §§ 2, 3; 1979, No. 679, §§ 2, 3; 1983, No. 131, §§ 1-3, 5; 1983, No. 135, §§ 1-3, 5; A.S.A. 1947, §§ 6-623 — 6-626, 82-4102, 82-4103.

20-8-303. Acts 1979, No. 246, §§ 4, 6; 1979, No. 679, §§ 4, 6; A.S.A. 1947, §§ 82-4104, 82-4106.

20-8-304. Acts 1979, No. 246, § 5; 1979, No. 679, § 5; A.S.A. 1947, § 82-4105.

20-8-305. Acts 1979, No. 246, § 6; 1979, No. 679, § 6; A.S.A. 1947, § 82-4106.

Acts 1991, No. 343, § 8, provided: “The Home Health Coordinating Council created under Arkansas Code § 20-8-302 is abolished.”

20-8-301. Findings.

The General Assembly finds:

1. That Arkansas consistently ranks among the most unhealthy states in the nation;
2. That after just one (1) year of regular walking exercise, previously sedentary smokers refrained from smoking at two (2) times the rate of those who received only health education;
3. That Arkansans who exercise regularly choose walking as their overwhelmingly preferred form of activity;
4. That women who walk briskly or exercise vigorously may reduce their chances for heart disease by as much as forty percent (40%);
5. That more than thirty-five percent (35%) of Arkansans do not exercise, placing Arkansas as the sixth most sedentary state in the nation;
6. That, while people are inactive in all parts of the state, a greater percentage of the population in rural areas is inactive; and
7. That a reduction in illnesses related to physical inactivity would save Arkansas millions of dollars each year in reduced healthcare costs.

History. Acts 2001, No. 1750, § 1.

20-8-302. Use of funds — Rules.

1. The Department of Health shall use funds from the Tobacco Settlement Proceeds Act, § 19-12-101 et seq., to establish the Great Strides Grant Program.
2. 1. The department shall promulgate rules to create a grant program which will allow local communities to participate in the Great Strides Grant Program.
   2. The department shall give priority in meeting the goals of this subchapter to grant proposals from rural communities.

History. Acts 2001, No. 1750, § 2; 2019, No. 315, § 1826.

Amendments. The 2019 amendment substituted “rules” for “regulations” in (b)(1).

Subchapter 4 — Health Data Initiative

Effective Dates. Acts 2019, No. 910, § 6346(b): July 1, 2019. Emergency clause provided: “It is found and determined by the General Assembly of the State of Arkansas that this act revises the duties of certain state entities; that this act establishes new departments of the state; that these revisions impact the expenses and operations of state government; and that the sections of this act other than the two uncodified sections of this act preceding the emergency clause titled ‘Funding and classification of cabinet-level department secretaries’ and ‘Transformation and Efficiencies Act transition team’ should become effective at the beginning of the fiscal year to allow for implementation of the new provisions at the beginning of the fiscal year. Therefore, an emergency is declared to exist, and Sections 1 through 6343 of this act being necessary for the preservation of the public peace, health, and safety shall become effective on July 1, 2019”.

20-8-401. Legislative findings.

The General Assembly finds and determines that there is a lack of Arkansas-specific information and data to guide officials responsible for policy decisions and that making this data readily available to decision makers is essential to the creation of effective health policy for the state.

History. Acts 2003, No. 1035, § 1.

20-8-402. Program creation and administration.

1. 1. The Director of the Arkansas Center for Health Improvement shall establish and maintain a program to access health data to be known as the “Arkansas Health Data Initiative”.
   2. The initiative shall be administered and maintained within the the Arkansas Center for Health Improvement.
2. The purpose of the initiative is to serve as an access point for studies concerning state and federal health information and to inform and support Arkansas health policy officials.
3. Policy development and access to data under the initiative is contingent upon the availability of funding to support projects under the initiative.

History. Acts 2003, No. 1035, § 2.

20-8-403. Data access.

1. If agreed to by state agencies responsible for maintaining requested data sources, the Arkansas Center for Health Improvement may have access to the agencies' information and data to facilitate operation of the Arkansas Health Data Initiative.
2. Data under subsection (a) of this section include:
   1. Public health databases;
   2. Healthcare-utilization data;
   3. Financial data related to the procurement of health or healthcare-related services;
   4. Data supplied as part of mandated reporting requirements to state agencies by entities, including, but not limited to, other state agencies and departments, nonstate entities, external vendors, and other entities as identified by the initiative;
   5. Data collected and maintained under the State Health Data Clearinghouse Act, § 20-7-301 et seq.; and
   6. Other data sources supported and maintained with state funds.

History. Acts 2003, No. 1035, § 3.

20-8-404. Rules.

The Division of Information Systems, Department of Finance and Administration, Department of Health, Department of Human Services, State Insurance Department, and all other appropriate departments, agencies, subcontractors, and officers shall promulgate rules to implement this subchapter.

History. Acts 2003, No. 1035, § 4; 2019, No. 910, § 6118.

Amendments. The 2019 amendment substituted “Division of Information Systems” for “Department of Information Systems”.

Subchapter 5 — Newborn Umbilical Cord Blood Initiative Act

A.C.R.C. Notes. The Newborn Umbilical Cord Blood Bank established by this subchapter is also called the Cord Blood Bank of Arkansas.

Effective Dates. Identical Acts 2016 (3rd Ex. Sess.), Nos. 2 and 3, § 129: May 23, 2016. Emergency clause provided: “It is found and determined by the General Assembly of the State of Arkansas that this act revises the membership and duties of certain agencies, task forces, committees, and commissions and repeals other governmental entities; that these revisions and repeals of governmental entities impact the expenses and operations of state government; and that the provisions of this act should become effective as soon as possible to allow for implementation of the new provisions in advance of the upcoming fiscal year. Therefore, an emergency is declared to exist, and this act being immediately necessary for the preservation of the public peace, health, and safety shall become effective on: (1) The date of its approval by the Governor; (2) If the bill is neither approved nor vetoed by the Governor, the expiration of the period of time during which the Governor may veto the bill; or (3) If the bill is vetoed by the Governor and the veto is overridden, the date the last house overrides the veto.”

Acts 2019, No. 910, § 6346(b): July 1, 2019. Emergency clause provided: “It is found and determined by the General Assembly of the State of Arkansas that this act revises the duties of certain state entities; that this act establishes new departments of the state; that these revisions impact the expenses and operations of state government; and that the sections of this act other than the two uncodified sections of this act preceding the emergency clause titled ‘Funding and classification of cabinet-level department secretaries’ and ‘Transformation and Efficiencies Act transition team’ should become effective at the beginning of the fiscal year to allow for implementation of the new provisions at the beginning of the fiscal year. Therefore, an emergency is declared to exist, and Sections 1 through 6343 of this act being necessary for the preservation of the public peace, health, and safety shall become effective on July 1, 2019”.

20-8-501. Title.

This subchapter shall be known and may be cited as the “Newborn Umbilical Cord Blood Initiative Act”.

History. Acts 2007, No. 695, § 1.

20-8-502. Legislative findings.

The General Assembly finds that:

1. More than one hundred million (100,000,000) Americans and two billion (2,000,000,000) other humans worldwide suffer from diseases that may eventually be treated more effectively or even cured with stem cells;
2. Stem cell research has been hampered by the controversy over the use of embryonic stem cells;
3. Stem cells are not found only in embryos;
4. The umbilical cord, placenta, and amniotic fluid are rich in stem cells that may be used for scientific research and medical treatment without destroying embryos;
5. Stem cell research using stem cells from postnatal tissue and fluid has already resulted in treatments for anemia, leukemia, lymphoma, lupus, multiple sclerosis, rheumatoid arthritis, sickle cell disease, spinal cord injury, and Crohn's disease;
6. Stem cell therapies using stem cells from postnatal tissue and fluid are being studied for diseases as wide-ranging and diverse as corneal degeneration, heart disease, stroke, Parkinson's disease, and Alzheimer's disease;
7. It is the public policy of this state to encourage the donation, collection, and storage of stem cells collected from postnatal tissue and fluid and to make such stem cells available for both scientific research and medical treatment; and
8. It is the public policy of this state to encourage ethical research in life science and regenerative medicine.

History. Acts 2007, No. 695, § 1.

20-8-503. Definitions.

As used in this subchapter:

1. “Amniotic fluid” means the fluid inside the amnion;
2. “Nonembryonic stem cell research” means medical research involving stem cells that have not been derived from a human embryo or fetus;
3. “Placenta” means the organ that forms on the inner wall of the human uterus during pregnancy;
4. “Postnatal tissue and fluid” means the placenta, umbilical cord, and amniotic fluid expelled or extracted in connection with the birth of a human being;
5. “Stem cell” means an unspecialized or undifferentiated cell that can self-replicate and has the potential to differentiate into a specialized cell type; and
6. “Umbilical cord” means the gelatinous tissue and blood vessels connecting an unborn human being to the placenta.

History. Acts 2007, No. 695, § 1.

20-8-504. Newborn Umbilical Cord Blood Initiative.

1. 1. On or before June 30, 2008, the Arkansas Commission for the Newborn Umbilical Cord Blood Initiative shall establish a network of postnatal tissue and fluid banks in partnership with one (1) or more public or private colleges or universities, public or private hospitals, nonprofit organizations, or private firms in this state for the purpose of collecting and storing postnatal tissue and fluid.
   2. The Newborn Umbilical Cord Blood Bank shall create a voluntary program to make tissue and fluid available for scientific research and medical treatment in accordance with this subchapter.
   3. A parent of a child born in this state may voluntarily contribute postnatal tissue and fluid to the Newborn Umbilical Cord Blood Bank.
2. 1. The commission shall develop a voluntary program to educate pregnant patients with respect to the banking of postnatal tissue and fluid.
   2. The program shall include:
      1. An explanation of the difference between public and private postnatal tissue and fluid banking programs;
      2. The medical process involved in the collection and storage of postnatal tissue and fluid;
      3. The current and potential future medical uses of stored postnatal tissue and fluid;
      4. The benefits and risks involved in the banking of postnatal tissue and fluid; and
      5. The availability and cost of storing postnatal tissue and fluid in public and private umbilical cord blood banks.

History. Acts 2007, No. 695, § 1.

20-8-505. Arkansas Commission for the Newborn Umbilical Cord Blood Initiative — Creation — Members.

1. The Arkansas Commission for the Newborn Umbilical Cord Blood Initiative is created.
2. 1. The commission shall consist of eleven (11) members appointed as follows:
      1. Three (3) members appointed by the Governor as follows:
         1. One (1) member who is a physician licensed by the Arkansas State Medical Board;
         2. One (1) member who has a financial background; and
         3. One (1) member who has a legal background or an ethicist background, or both;
      2. Three (3) members appointed by the Speaker of the House of Representatives as follows:
         1. One (1) member who is a physician licensed by the board;
         2. One (1) member who has a financial background; and
         3. One (1) member who has a legal background or an ethicist background, or both;
      3. Three (3) members appointed by the President Pro Tempore of the Senate as follows:
         1. One (1) member who is a physician licensed by the board;
         2. One (1) member who has a financial background; and
         3. One (1) member who has a legal background or an ethicist background, or both;
      4. The Dean of the Fay W. Boozman College of Public Health of the University of Arkansas for Medical Sciences or his or her designee; and
      5. The Secretary of the Department of Health or his or her designee.
   2. The commission shall include one (1) consultant, nonvoting member who shall be the Director of Cell Therapy and Transfusion Medicine of the University of Arkansas for Medical Sciences.
3. The Governor shall designate one (1) member as chair of the commission.
4. The chair shall call the first meeting of the commission within sixty (60) days of his or her appointment.
5. 1. At the first meeting of the commission, the members shall draw lots so that three (3) members serve two-year terms, three (3) members serve three-year terms, and three (3) members serve four-year terms.
   2. After the initial terms, members shall serve four-year terms.
6. The commission shall meet at least one (1) time per year.
7. 1. A majority of the membership of the commission shall constitute a quorum.
   2. A majority vote of those members present shall be required for any action of the commission.
8. Vacancies on the commission due to death, resignation, removal, or other causes shall be filled in the same manner as is provided in this section for initial appointments.

History. Acts 2007, No. 695, § 1; 2016 (3rd Ex. Sess.), No. 2, § 34; 2016 (3rd Ex. Sess.), No. 3, § 34; 2019, No. 910, § 4961.

A.C.R.C. Notes. Identical Acts 2016 (3rd Ex. Sess.), Nos. 2 and 3, § 1, provided:

“(a) The General Assembly finds:

“(1) State government provides vital functions that impact the lives of Arkansas citizens on a daily basis;

“(2) While these functions are important, it is equally important to ensure that state government operates efficiently and effectively to eliminate unnecessary spending of tax dollars and provide timely and quality services to Arkansas citizens; and

“(3) Issues such as the administrative organization of a governmental entity, the appointment structure of a governmental entity's governing board, and extraneous duties assigned to governmental entities hamper the operation of state government and result in unnecessary expenses and delays in the provision of state services.

“(b) It is the intent of this act to amend provisions of law applicable to certain agencies, task forces, committees, and commission to promote efficiency and effectiveness in the operations of state government as a whole.”

Amendments. The 2016 (3rd Ex. Sess.) amendment by identical acts Nos. 2 and 3 substituted “one (1) time per year” for “quarterly” at the end of (f).

The 2019 amendment substituted “Secretary of the Department of Health” for “Director of the Department of Health” in (b)(1)(E).

20-8-506. Arkansas Commission for the Newborn Umbilical Cord Blood Initiative — Powers and duties.

1. The Arkansas Commission for the Newborn Umbilical Cord Blood Initiative shall:
   1. Investigate the implementation of this subchapter and recommend improvements in this subchapter to the General Assembly;
   2. Make available to the public the records of all meetings of the commission and of all business transacted by the commission;
   3. Oversee the operations of the Newborn Umbilical Cord Blood Bank, including without limitation the approval of all fees established to cover administration, collection, and storage costs;
   4. Undertake the Newborn Umbilical Cord Blood Initiative by promoting awareness of the blood bank and encouraging donation of postnatal tissue and fluid to the blood bank;
   5. Ensure the privacy of persons who donate umbilical cord blood, amniotic fluid, and placental tissue to the blood bank;
   6. Develop a plan for making postnatal tissue and fluid collected under the Newborn Umbilical Cord Blood Initiative available for scientific research and medical treatment in compliance with all relevant national practice and quality standards;
   7. Develop a plan for private storage of postnatal tissue and fluid for medical treatment;
   8. Participate in the National Cord Blood Program and register postnatal tissue and fluid collected with registries operating in connection with the National Cord Blood Program;
   9. If funds are available, request the Department of Health to employ staff and enter into contracts necessary to implement this subchapter, and reimburse the department for the cost of implementing this subchapter; and
   10. Report annually to the General Assembly on or before October 1 of each year concerning the activities of the commission.
2. The commission may seek additional funding from any source, including without limitation federal grants and private grants.

History. Acts 2007, No. 695, § 1; 2019, No. 910, § 4962.

Amendments. The 2019 amendment, in (a)(9), inserted “request the Department of Health to” and “and reimburse the Department of Health for the cost of implementing this subchapter”.

Subchapter 6 — Alzheimer's Advisory Council

20-8-601 — 20-8-604. [Repealed.]

A.C.R.C. Notes. Identical Acts 2016 (3rd Ex. Sess.), Nos. 2 and 3, § 127, provided: “Sections of the Arkansas Code amended by this act that expire on or before September 30, 2017, may be removed from the Arkansas Code by the Arkansas Code Revision Commission after their respective expiration date.”

Publisher's Notes. This subchapter, concerning the Alzheimer's Advisory Council, was repealed by Acts 2019, No. 389, § 11, effective July 24, 2019, and Acts 2019, No. 910, § 4963, effective July 1, 2019. The subchapter was derived from the following sources:

20-8-601. Acts 2011, No. 889, § 1; 2013, No. 1510, § 1; 2016 (3rd Ex. Sess.), No. 2, § 35; 2016 (3rd Ex. Sess.), No. 3, § 35.

20-8-602. Acts 2011, No. 889, § 1; 2013, No. 1510, § 2; 2016 (3rd Ex. Sess.), No. 2, § 36; 2016 (3rd Ex. Sess.), No. 3, § 36; 2017, No. 913, § 53.

20-8-603. Acts 2011, No. 889, § 1; 2013, No. 1510, § 3; 2016 (3rd Ex. Sess.), No. 2, § 37; 2016 (3rd Ex. Sess.), No. 3, § 37.

20-8-604. Acts 2011, No. 889, § 1; 2013, No. 1510, § 4; 2016 (3rd Ex. Sess.), No. 2, § 38; 2016 (3rd Ex. Sess.), No. 3, § 38.

This subchapter had previously expired by its own terms on September 30, 2017, and had been removed from the Arkansas Code as provided by Identical Acts 2016 (3rd Ex. Sess.), Nos. 2 and 3, § 127.

Subchapter 7 — Palliative Care

Effective Dates. Acts 2019, No. 910, § 6346(b): July 1, 2019. Emergency clause provided: “It is found and determined by the General Assembly of the State of Arkansas that this act revises the duties of certain state entities; that this act establishes new departments of the state; that these revisions impact the expenses and operations of state government; and that the sections of this act other than the two uncodified sections of this act preceding the emergency clause titled ‘Funding and classification of cabinet-level department secretaries’ and ‘Transformation and Efficiencies Act transition team’ should become effective at the beginning of the fiscal year to allow for implementation of the new provisions at the beginning of the fiscal year. Therefore, an emergency is declared to exist, and Sections 1 through 6343 of this act being necessary for the preservation of the public peace, health, and safety shall become effective on July 1, 2019”.

20-8-701. Definitions.

As used in this subchapter:

1. “Palliative care” means patient-centered and family-centered medical care offered throughout the continuum of an illness that optimizes quality of life by anticipating, preventing, and treating the suffering caused by a serious illness to address physical, emotional, social, and spiritual needs and facilitate patient autonomy, access to information, and choice, including without limitation:
   1. Discussion of the patient's goals for treatment;
   2. Discussions of treatment options appropriate to the patient, including hospice care, if needed; and
   3. Comprehensive pain and symptom management; and
2. “Serious illness” means a medical illness or physical injury or condition that substantially impacts quality of life for more than a short period of time, including without limitation cancer, renal failure, liver failure, heart disease, lung disease, and Alzheimer's disease and related dementia.

History. Acts 2017, No. 735, § 1.

20-8-702. Palliative Care and Quality of Life Interdisciplinary Task Force — Creation — Membership.

1. There is created the Palliative Care and Quality of Life Interdisciplinary Task Force.
2. The task force shall consist of thirteen (13) members as follows:
   1. Nine (9) members appointed by the Governor as follows:
      1. One (1) member who is a designee of the American Cancer Society;
      2. One (1) member who is a designee of the Hospice and Palliative Care Association of Arkansas, Inc.;
      3. One (1) member who is a designee of the Department of Veterans Affairs;
      4. One (1) member who is a designee of the American Heart Association, Arkansas Affiliate, Inc.;
      5. One (1) member who is a designee of the Arkansas Hospital Association, Inc.;
      6. One (1) member who is a designee of the Arkansas Medical Society, Inc.;
      7. One (1) member who is a designee of the Arkansas Health Care Association;
      8. One (1) member who is a designee of the Arkansas Center for Health Improvement; and
      9. One (1) member, who is appointed in consultation with the Secretary of the Department of Health, who is a palliative care professional with expertise in the following knowledge areas that may include without limitation:
         1. Interdisciplinary palliative care;
         2. Medical, nursing, social work, pharmacy, or spiritual services;
         3. Psychosocial issues involved in caregiving for patient and family caregivers or their advocates; and
         4. Palliative care perspectives and challenges across multiple settings, including inpatient, outpatient, and community settings, and across pediatric, youth, adult, and geriatric populations;
   2. Two (2) members appointed by the President Pro Tempore of the Senate as follows:
      1. One (1) member who is a board-certified hospice and palliative medicine physician, physician assistant, or nurse; and
      2. One (1) member, in consultation with the Arkansas Surgeon General, who is a palliative care professional with expertise in the following knowledge areas that may include without limitation:
         1. Interdisciplinary palliative care;
         2. Medical, nursing, social work, pharmacy, or spiritual services;
         3. Psychosocial issues involved in caregiving for patient and family caregivers or their advocates; and
         4. Palliative care perspectives and challenges across multiple settings, including inpatient, outpatient, and community settings, and across pediatric, youth, adult, and geriatric populations; and
   3. Two (2) members appointed by the Speaker of the House of Representatives as follows:
      1. One (1) member who is a board-certified hospice and palliative medicine physician, physician assistant, advanced practice registered nurse, or nurse; and
      2. One (1) member, in consultation with the Arkansas Surgeon General, who is a palliative care professional with expertise in the following knowledge areas that may include without limitation:
         1. Interdisciplinary palliative care;
         2. Medical, nursing, social work, pharmacy, or spiritual services;
         3. Psychosocial issues involved in caregiving for patient and family caregivers or their advocates; and
         4. Palliative care perspectives and challenges across multiple settings, including inpatient, outpatient, and community settings, and across pediatric, youth, adult, and geriatric populations.
3. The members of the task force shall be appointed by September 1, 2017.
4. In the event of a vacancy in the membership of the task force, a person shall be appointed by the appropriate individual and who meets the applicable eligibility requirements of the vacated position to fill the vacancy for the remainder of the term.
5. 1. The task force shall select a chair and vice chair during the first meeting.
   2. The task force shall hold at least two (2) regular meetings in each calendar year at a time and place determined by the task force.
6. Seven (7) members of the task force shall constitute a quorum to transact business.
7. The members of the task force may receive expense reimbursement in accordance with § 25-16-901 et seq.
8. The Department of Health shall provide staff, information, and other assistance as reasonably necessary to assist the task force in its efficient organization.
9. The purpose of the task force is to consult with and advise the Department of Health on matters relating to the establishment, maintenance, operation, and outcome evaluation of palliative care initiatives in the state.
10. The task force shall expire on December 31, 2021, unless extended by the General Assembly.

History. Acts 2017, No. 735, § 1; 2019, No. 813, § 1; 2019, No. 910, §§ 4964-4967.

Amendments. The 2019 amendment by No. 813 substituted “2021” for “2019” in (j).

The 2019 amendment by No. 910, in the introductory language of (b)(1)(I), inserted “who is appointed” and substituted “Secretary of the Department of Health” for “Surgeon General”; substituted “Arkansas Surgeon General” for “Surgeon General” in the introductory language of (b)(2)(B) and the introductory language of (b)(3)(B); and deleted “in conjunction with the Department of Human Services” following “Department of Health” in (h).

20-8-703. Reports.

1. The Palliative Care and Quality of Life Interdisciplinary Task Force shall submit a preliminary report to the Governor, President Pro Tempore of the Senate, and the Speaker of the House of Representatives on or before January 17, 2019, that includes without limitation:
   1. Recommendations for the establishment, maintenance, operation, and outcome evaluation of palliative care initiatives in the state; and
   2. Recommendations for any statutory changes to be considered by the General Assembly.
2. The task force shall submit a follow-up report to the Governor, President Pro Tempore of the Senate, and the Speaker of the House of Representatives on or before December 31, 2020, detailing the implementation of the recommendations from the preliminary report.
3. On and after August 1, 2017, the task force shall submit and present a quarterly report to the Senate Committee on Public Health, Welfare, and Labor and the House Committee on Public Health, Welfare, and Labor.

History. Acts 2017, No. 735, § 1.

Subchapter 8 — Volunteer Health Care Act

20-8-801. Title.

This subchapter shall be known and may be cited as the “Volunteer Health Care Act”.

History. Acts 2017, No. 958, § 1.

20-8-802. Legislative purpose.

It is the purpose of the General Assembly to:

1. Provide and facilitate access to appropriate, safe, and cost-effective healthcare services; and
2. Maintain healthcare quality.

History. Acts 2017, No. 958, § 1.

20-8-803. Definitions.

As used in this subchapter:

1. “Contract” means an agreement executed in compliance with this subchapter between a healthcare professional or a medical professional and the Department of Health or a governmental contractor;
2. “Governmental contractor” means the county health units, special purpose districts with healthcare responsibilities, a hospital owned and operated by a governmental entity, or any other healthcare entity designated by the department;
3. “Healthcare provider” means:
   1. A free or charitable healthcare clinic qualified as exempt from federal income taxation;
   2. A state or federally funded community health center;
   3. A volunteer corporation or volunteer healthcare provider that delivers healthcare services to low-income patients; and
   4. Other medical facilities with the primary purpose to deliver medical services or treatment to humans and that include an office maintained by a medical professional;
4. “Low-income patient” means a person who:
   1. Is eligible for any category of the Arkansas Medicaid Program; or
   2. Does not have health insurance and whose annual household income does not exceed three hundred percent (300%) of the federal poverty level; and
5. “Medical professional” means:
   1. A physician, osteopathic physician, or optometric physician;
   2. An osteopathic physician's assistant, physician's assistant, or optometric physician's assistant;
   3. A chiropractic physician;
   4. A podiatric physician;
   5. A nurse licensed under § 17-87-101 et seq.;
   6. A dentist or dental hygienist;
   7. A pharmacist;
   8. An optometrist;
   9. A dietitian or an individual who offers dietary services; and
   10. A student enrolled in an accredited program that prepares the student for licensure in one (1) or more of the healthcare professions listed in subdivisions (5)(A)-(H) of this section.

History. Acts 2017, No. 958, § 1.

20-8-804. Volunteer Healthcare Program.

1. 1. A healthcare provider or medical professional may enter into a contract with the Department of Health or governmental contractor to deliver volunteer health services to eligible low-income patients.
   2. A healthcare provider or medical professional that enters into a contract as described in subdivision (a)(1) of this section shall be an agent of the state with sovereign immunity while the healthcare provider or medical professional is acting within the scope of duties under the contract as described in this subchapter.
   3. A governmental contractor that is also a healthcare provider is not required to enter into a contract under this subchapter with respect to the healthcare services delivered by employees of the governmental contractor.
2. The contract shall:
   1. Apply only to volunteer healthcare services delivered by the healthcare provider or medical professional to low-income patients who are eligible to receive healthcare services;
   2. Include all employees of the healthcare provider; and
   3. State that:
      1. The healthcare provider or medical professional has sovereign immunity and may not be named as a defendant in an action arising due to medical care or treatment provided within the scope of the contract;
      2. If a patient treated by the healthcare provider or medical professional is ineligible for services, the healthcare provider or medical professional shall still have sovereign immunity and may not be named as a defendant in an action arising due to medical care or treatment provided;
      3. The department or the governmental contractor has the right to:
         1. Dismiss or terminate any healthcare provider or medical professional employed under the contract; and
         2. 1. Terminate the contact with a healthcare provider or medical professional with appropriate cause.
            2. At least five (5) business days before the termination date of a contract, the department or governmental contractor shall provide the healthcare provider or medical professional with written notice of intent to terminate the contract and reasons for the decision; and
         3. Access the records of any patient served by the healthcare provider or medical professional under the contract;
      4. 1. The healthcare provider or medical professional shall report any adverse incidents and information on treatment outcomes to the department or governmental contractor if pertaining to a patient treated under the contract.
         2. The healthcare provider or medical professional shall also report the adverse incident to the appropriate licensing body to determine whether the adverse incident involves conduct subject to disciplinary action.
         3. Patient medical records and identifying information contained in the adverse incident report shall be confidential and not subject to the Freedom of Information Act of 1967, § 25-19-101 et seq.;
      5. The department, governmental contractor, healthcare provider, or medical provider may make patient selection and initial referrals; and
      6. If emergency care is required, the patient shall be referred within forty-eight (48) hours after the latter of the time when treatment commences or the patient has the mental capacity to consent to treatments.
3. Annually, the healthcare provider or medical professional shall report the following information to the department:
   1. A summary of the efficacy of access and treatment outcomes;
   2. Statistics for claims pending and claims paid;
   3. The amount of defense and handling costs associated with all claims brought against healthcare providers or medical professionals by the healthcare provider or medical professional working under the Volunteer Healthcare Program;
   4. The operation hours of the healthcare provider or medical professional;
   5. The number of patient visits by the healthcare provider or medical professional working under the Volunteer Healthcare Program; and
   6. The value of healthcare-related goods and services provided by the healthcare provider or medical professional working under the Volunteer Healthcare Program.

History. Acts 2017, No. 958, § 1.

20-8-805. Continuing education credit.

1. A medical professional may fulfill one (1) hour of continuing education credit with the performance of eight (8) hours of volunteer services under this subchapter.
2. A medical professional shall not obtain more than eight (8) hours of credits as described in subsection (a) of this section in a licensing period.

History. Acts 2017, No. 958, § 1.

20-8-806. Notice of agency relationship.

1. The healthcare provider or medical professional shall provide written notice to each patient, parent of the patient, or legal guardian of the patient served under a contract described in this subchapter.
2. The written notice shall:
   1. Be acknowledged in writing by the patient, the parent of the patient, or the legal guardian of the patient; and
   2. Contain information that:
      1. The healthcare provider or medical professional is an agent of the state; and
      2. The exclusive remedy for damage or injury suffered as a result of any act or omission by the healthcare provider or medical professional acting within the scope of duties under a contract described in this subchapter is to file a claim in the Arkansas State Claims Commission.
3. The healthcare provider or medical professional may comply with the requirements of subdivisions (b)(2)(A) and (B) of this section by posting the notice in a conspicuous place within the place of business of the healthcare provider or medical professional.

History. Acts 2017, No. 958, § 1.

20-8-807. Reports.

1. Annually, the Department of Health shall report to:
   1. The President Pro Tempore of the Senate;
   2. The Speaker of the House of Representatives;
   3. The minority leaders of the Senate and the House of Representatives;
   4. The Chair of the Senate Committee on Public Health, Welfare, and Labor; and
   5. The Chair of the House Committee on Public Health, Welfare, and Labor.
2. The report shall include without limitation:
   1. A summary of the efficacy of access and treatment outcomes;
   2. Statistics for claims pending and claims paid;
   3. The amount of defense and handling costs associated with all claims brought against healthcare providers or medical professionals under the Volunteer Healthcare Program;
   4. A listing of all healthcare providers and medical professionals volunteering under the Volunteer Healthcare Program with the operation hours of each healthcare provider and medical professional;
   5. The number of patient visits under the Volunteer Healthcare Program; and
   6. The value of healthcare-related goods and services provided by the Volunteer Healthcare Program.

History. Acts 2017, No. 958, § 1.

20-8-808. Malpractice litigation costs.

A governmental contractor is responsible for costs and attorney's fees for malpractice litigation arising out of healthcare services delivered under a contract brought to the Arkansas State Claims Commission.

History. Acts 2017, No. 958, § 1.

20-8-809. Rule promulgation.

The Department of Health shall promulgate rules necessary to implement this subchapter in a manner consistent with the purpose of this subchapter.

History. Acts 2017, No. 958, § 1.

Subchapter 9 — Primary Prevention Programs Act

A.C.R.C. Notes. Acts 2019, No. 841, § 1, provided: “Legislative findings.

The General Assembly finds that:

“(1) Research shows that the earlier an individual engages in risk behaviors, the more prone that individual is to addiction, unhealthy relationship development, and long-term negative life consequences;

“(2) Primary prevention and risk avoidance strategies help youth to develop personal efficacy, refusal skills, boundary and goal-setting skills, healthy relationships;

“(3) Providing skills that encourage a delayed initiation into or avoidance of participation in risk behaviors also delays initiation into and encourages cessation of other risk behaviors;

“(4) Intentional repetition of a primary prevention message is important in order to continually reinforce a healthy lifestyle; and

“(5) A primary prevention strategy should be the statewide health and educational approach when addressing and preventing youth participation in risk behaviors”.

20-8-901. Title.

This subchapter shall be known and may be cited as the “Primary Prevention Programs Act”.

History. Acts 2019, No. 841, § 2.

20-8-902. Definitions.

As used in this subchapter:

1. “At-risk youth” means an individual in grades kindergarten through twelve (K-12) who has a greater vulnerability for risk behaviors;
2. “Client” means the intended audience of a primary prevention and risk avoidance program;
3. “Culturally appropriate” means effective for communicating with people of different cultures, including without limitation people of different races and ethnicities;
4. “Developmentally appropriate” means:
   1. Suited to the physical, intellectual, and emotional development of an adolescent; and
   2. Taking into consideration the following:
      1. During adolescence, physical changes happen at an increased rate;
      2. At the same time, adolescents experience cognitive, social, emotional, and interpersonal changes that must be addressed as part of a primary prevention strategy; and
      3. Although all youth have individual personalities and individual interests, many adolescents face similar developmental issues during early, middle, and late adolescence that must be addressed at the appropriate times;
5. “Evidence-based” means founded on:
   1. Principles and concepts supported by research;
   2. Practical strategies learned from experience; and
   3. Practices consistent with client needs and circumstances;
6. “Evidence-informed” means incorporating available evidence, practice, and experience to determine what works in a given, practical setting;
7. 1. “Optimal health” means the following aspects of health without limitation:
      1. Physical health, which refers to the physiological way an individual's body functions;
      2. Emotional health, which includes without limitation an individual's ability to calmly cope with unpleasant emotions and remain aware of the individual's and others' feelings;
      3. Social health, which refers to the quality of an individual's relationships with the individual's family, friends, and others with whom the individual interacts;
      4. Mental health, which includes without limitation an individual's ability to recognize reality and cope with the demands of daily life while maintaining self-esteem and self-respect; and
      5. Spiritual health, which refers to an individual's choice to live his or her life in accordance with his or her ethics, morals, values, and in harmony with his or her environment and others that surround him or her.
   2. “Optimal health” is not limited to the absence of disease;
8. “Primary prevention strategy” means a plan of action that utilizes a prevention-first educational approach to risk behavior that:
   1. Employs strategies that prevent risk behaviors and assist with the transition of youth from risk behavior lifestyles and habits to risk-free lifestyles and habits before negative health effects occur; and
   2. Includes primarily content that prioritizes a risk avoidance message;
9. “Proven effective” means that a program, project, approach, or practice has been recognized as evidence-based or evidence-informed by a credible federal or state education or health entity;
10. “Risk avoidance strategy” means a plan of action that:
    1. Encourages students to voluntarily avoid or refrain from risk behaviors and eliminate all associated risks of those behaviors; and
    2. Educates students about the optimal health of an individual and the societal benefits associated with:
       1. Personal responsibility;
       2. Personal efficacy;
       3. Goal setting;
       4. Health decision-making;
       5. A focus on the future; and
       6. Healthy relationship development;
11. “Risk behavior” includes without limitation the following:
    1. Smoking;
    2. Consuming alcohol;
    3. Abusing drugs;
    4. Early initiation into sexual activity;
    5. Participating in a sexually active lifestyle while under the age of legal consent;
    6. Engaging in or having experienced:
       1. Dating violence; or
       2. Sexual violence; and
    7. Participating in illegal activities such as:
       1. Misusing technology and social media, which includes without limitation the following:
          1. Blackmailing another person with pictures or information gained through technology or social media;
          2. Cyberbullying, as defined in § 5-71-217; and
          3. Sexting, as defined in § 5-27-609; and
       2. 1. Bullying.
          2. A primary prevention program shall address the:
             1. Behaviors of a teen who is bullying another person; and
             2. Effects of bullying on a teen who is being bullied by another person;
                1. A positive youth development approach that builds on a person's existing strengths, skills, and external assets;
                2. Medically accurate information that is supported by research by medical, psychological, scientific, governmental, or public health publications, organizations, or agencies; and
                3. Evidence-based or evidence-informed practice.
12. “Secondary prevention strategy” means a plan of action that encourages reducing risks associated with risk behaviors; and
13. “Strength-based” means founded on the following:

History. Acts 2019, No. 841, § 2.

20-8-903. Primary prevention and risk avoidance programs.

1. 1. If an education program concerning risk behavior is provided to a youth by or through a state agency or public school, the education program shall utilize a primary prevention and risk avoidance program.
   2. Secondary prevention strategies that focus on risk reduction rather than risk avoidance may be used only after a primary prevention and risk avoidance strategy has been used.
2. 1. A state agency or public school may partner or contract with a person, firm, corporation, or other organization to provide a primary prevention and risk avoidance program or training under this subchapter.
   2. In order to ensure consistency among primary prevention strategies across the state, a program partner or contracted provider shall receive training from a trainer that shall:
      1. Have experience in providing primary prevention and risk avoidance programs;
      2. Have a reference from one (1) or more school districts;
      3. Have as its foundation programming based on:
         1. Risk avoidance;
         2. Evidence-based information; or
         3. Evidence-informed information; and
      4. Have at least five (5) years of experience in:
         1. Training;
         2. Implementing programs in the classroom and the community; and
         3. Collaborating with one (1) or more school districts and one (1) or more communities.

History. Acts 2019, No. 841, § 2.

Subchapter 10 — Life Choices Lifeline Program

20-8-1001. Life Choices Lifeline Program.

1. The Department of Health may implement the Life Choices Lifeline Program as a statewide care program to provide direct services, support, social services case management, and referrals to biological parents of unborn children and biological or adoptive parents of children under two (2) years of age.
2. The Life Choices Lifeline Program shall:
   1. Encourage healthy childbirth;
   2. Support childbirth as an alternative to abortion;
   3. Promote family formation;
   4. Aid successful parenting; and
   5. Increase families' economic self-sufficiency.
3. Funding provided for services of the Life Choices Lifeline Program shall be used for nonsectarian purposes only.
4. The Life Choices Lifeline Program shall consist of at least the following components:
   1. Direct-to-participant marketing within the state;
   2. The use of licensed nurses to provide to participants in the Life Choices Lifeline Program:
      1. An assessment and evaluation of needs related to pregnancy or parenting; and
      2. Medically accurate pregnancy-related medical information;
   3. The use of licensed social workers, nurses, or other individuals of equivalent experience, to provide to participants in the Life Choices Lifeline Program:
      1. Development of a care plan of resources and support to address the needs identified;
      2. Referrals to appropriate local resources, including state and federal benefits programs and local charitable organizations;
      3. Assistance in applying for state and federal benefits programs; and
      4. Assistance in accomplishing elements of the care plan; and
   4. Administrative support and expenses directly attributable to the development of or ongoing support of services of the Life Choices Lifeline Program.
5. 1. The Life Choices Lifeline Program shall be available to residents of all counties of the state, including residents in rural areas that may currently lack access to services.
   2. Services of the Life Choices Lifeline Program may be provided, as appropriate, in person through existing facilities or remotely through a telephonic system or other comparable technological system.
6. To be eligible to receive services under the Life Choices Lifeline Program, an individual shall at the time of initial contact with the Life Choices Lifeline Program be:
   1. A resident of the state; and
   2. A biological parent of an unborn child or a biological or adoptive parent of a child under two (2) years of age.
7. Existing participants of the Life Choices Lifeline Program whose pregnancy is terminated before birth are eligible to continue to receive services of the Life Choices Lifeline Program for six (6) months after the date of termination.

History. Acts 2019, No. 1036, § 1.

Subchapter 1 — General Provisions

Cross References. Medical Corporation Act, § 4-29-301 et seq.

Effective Dates. Acts 1991, No. 1085, § 35: July 1, 1991. Emergency clause provided: “It is hereby found and determined by the Seventy-Eighth General Assembly, that the Constitution of the State of Arkansas prohibits the appropriation of funds for more than a two (2) year period; that the effectiveness of this Act on July 1, 1991 is essential to the operation of the agency for which the appropriations in this Act are provided, and that in the event of an extension of the Regular Session, the delay in the effective date of this Act beyond July 1, 1991 could work irreparable harm upon the proper administration and provision of essential governmental programs. Therefore, an emergency is hereby declared to exist and this Act being necessary for the immediate preservation of the public peace, health and safety shall be in full force and effect from and after July 1, 1991.”

20-9-101. Professional health service personnel — Parity.

1. Any additional compensation or allowances which may be made available to professional health service personnel at the University of Arkansas for Medical Sciences campus may also be made available to those in comparable positions in all divisions or offices of the Department of Human Services.
2. Professional health service personnel shall be limited to all nursing, occupational therapy, and physical therapy classifications.

History. Acts 1991, No. 1085, § 26.

A.C.R.C. Notes. Former § 20-9-101, concerning health professionals parity, is deemed to be superseded by this section. The former section was derived from Acts 1989 (1st Ex. Sess.), No. 68, § 14. A similar provision which was also codified as § 20-9-101, and was previously superseded, was derived from Acts 1985, No. 772, § 1.

20-9-102. [Repealed.]

Publisher's Notes. This section, concerning shaken baby syndrome educational materials, was repealed by Acts 2013, No. 1208, § 1. The section was derived from Acts 2011, No. 1128, § 1.

20-9-103. Pulse oximetry screening — Definition.

1. As used in this section, “birthing facility” means an inpatient or ambulatory healthcare facility licensed by the Department of Health that provides birthing services or newborn care services, or both.
2. Birthing facilities shall begin pulse oximetry testing for critical congenital heart defects on all newborns before discharge from the birthing facility no fewer than ninety (90) days and no more than one hundred eighty (180) days after the Department of Health complies with subsection (d) of this section.
3. To facilitate pulse oximetry testing for critical congenital heart defects on all newborns in the State of Arkansas before discharge from a birthing facility, Arkansas Children's Hospital shall:
   1. Provide written guidance on evidence-based guidelines on development of hospital policies and procedures related to pulse oximetry screening in newborns to the Department of Health and, on request, to an individual birthing facility;
   2. Provide the Department of Health with an educational document that may be distributed to parents or legal guardians of newborns regarding:
      1. The need for and performance of the pulse oximetry test;
      2. Methods for conducting the screening; and
      3. Common strategies for follow-up care in infants with abnormal screening results; and
   3. Through its Department of Pediatrics, provide to a birthing facility training and on-site technical assistance upon request in the performance of pulse oximetry testing.
4. To facilitate pulse oximetry testing for critical congenital heart defects on all newborns in the State of Arkansas before discharge from a birthing facility, the Department of Health shall:
   1. Develop an appropriate and functional system allowing for electronic submission of pulse oximetry test results by the hospital; and
   2. Provide technical assistance and training to the birthing facilities on the use of the system.
5. Testing results submitted to and compiled by the Department of Health under this section are confidential and are not subject to examination or disclosure as public information under the Freedom of Information Act of 1967, § 25-19-101 et seq.
6. The Department of Health shall not require the performance of a pulse oximetry test on a newborn if the parents or a legal guardian of the newborn object to the testing on medical, religious, or philosophical grounds.

History. Acts 2013, No. 768, § 2.

A.C.R.C. Notes. Acts 2013, No. 768, § 1, provided: “Findings. The General Assembly finds that:

“(1) Congenital heart defects:

“(A) Are structural abnormalities of the heart that are present at birth;

“(B) Range in severity from simple problems such as holes between chambers of the heart, to severe malformations such as complete absence of one (1) or more chambers of the heart;

“(C) May cause severe and life-threatening symptoms that require intervention within the first (5) days of birth; and

“(D) Are the number one killer of infants with birth defects;

“(2) Each year approximately fifty (50) infants out of approximately forty thousand (40,000) infants born in Arkansas will have a critical congenital heart defect;

“(3) In Arkansas, the infant mortality rate is seven-tenths percent of one percent (0.7%), while mortality among infants with a critical congenital heart defect is twenty-four and eight-tenths percent (24.8%);

“(4) Hospital costs for all infants with congenital heart defects can total two billion, six hundred million dollars ($2,600,000,000) per year, while the estimated cost of critical congenital heart defect screening with pulse oximetry is one dollar ($1.00) per year to ten dollars ($10.00) per year, per infant depending on the equipment and personnel performing the test;

“(5)(A) Current methods for detecting congenital heart defects generally include prenatal ultrasound screening and repeated clinical examinations designed to identify affected newborns.

“(B) The screenings alone identify less than one half (½) of all cases, and critical congenital heart defect cases are often missed during routine clinical exams performed before the newborn's discharge from a birthing facility;

“(6) Pulse oximetry is a noninvasive test that:

“(A) Estimates the percentage of hemoglobin in blood that is saturated with oxygen; and

“(B) When performed on newborns in delivery centers is effective at detecting critical, life-threatening congenital heart defects that otherwise go undetected by current screening methods;

“(7) Newborns with abnormal pulse oximetry results require immediate confirmatory testing and intervention; and

“(8) Many newborns' lives potentially could be saved by earlier detection and treatment of congenital heart defects if birthing facilities in Arkansas were required to perform this simple, noninvasive newborn screening in conjunction with current congenital heart disease screening methods.”

20-9-104. Nonparticipation in maintenance of licensure or maintenance of certification — Definitions.

1. As used in this section:
   1. “Maintenance of certification” means any process requiring periodic recertification examinations or other activities to maintain specialty medical certification; and
   2. “Specialty medical board certification” means a certification by a board that:
      1. Specializes in one (1) particular area of medicine; and
      2. Typically requires examinations that are in addition to the requirements of the Arkansas State Medical Board to practice medicine.
2. 1. Except as required by medical staff bylaws of a hospital, a hospital licensed by the Department of Health shall not deny physician hospital staff or admitting privileges or employment based solely on the absence of maintenance of certification.
   2. Subdivision (b)(1) of this section does not prevent a hospital from requiring physicians to undergo remedial or corrective courses or training as required by a quality improvement committee.

History. Acts 2019, No. 804, § 2.

Subchapter 2 — Health Facilities Services

A.C.R.C. Notes. References to “this subchapter” in §§ 20-9-201 — 20-9-221 may not apply to § 20-9-222 which was enacted subsequently.

Publisher's Notes. Acts 1961, No. 414, § 1, provided that Acts 1961, No. 414 (§§ 20-9-202 — 20-9-221) could be cited as the “Division of Hospital and Nursing Homes Act.”

Acts 1961, No. 414, § 29, provided, in part, that the specific intent of that act was to vest sole authority to license hospitals and nursing homes in the State Department of Public Health (now Department of Health).

Acts 1961, No. 414, codified in this subchapter, is also codified as §§ 20-10-214 — 20-10-228.

Preambles. Acts 1999, No. 506 contained a preamble which read:

“WHEREAS, the Arkansas Department of Health has been charged with the responsibility for conducting surveys of inpatient hospital facilities to ensure that each complies with the rules and regulations adopted by the Arkansas State Department of Health; and

“WHEREAS, the Joint Commission on Accreditation of Healthcare Organizations performs rigorous surveys in connection with its accreditation process, refusing accreditation to those hospitals which do not meet the Joint Commission on Accreditation of Healthcare Organizations' standards; and

“WHEREAS, many hospitals choose to engage the Joint Commission on Accreditation of Healthcare Organizations to perform surveys in order to receive accreditation; and

“WHEREAS, the Joint Commission on Accreditation of Healthcare Organization is recognized for the rigor of its surveys, which are performed on a regular schedule; and

“WHEREAS, forty-four (44) states recognize surveys and accreditation by the Joint Commission on Accreditation of Healthcare Organizations as adequate substitutes for state surveys and accordingly deem them to be sufficient to meet survey requirements, and

“WHEREAS, the duplicate surveys are costly to hospitals, leading to costs which are higher than would be necessary if only one (1) survey was required; and

“WHEREAS, it is in the public interest that Arkansas hospitals be surveyed by expert surveyors at the lowest cost for the provision of quality reviews.

“NOW THEREFORE, ... .”

Effective Dates. Acts 1965, No. 454, § 5: Mar. 20, 1965. Emergency clause provided: “It is found and declared by the General Assembly of Arkansas that Sections 8 and 22 of Act 414 of 1961 do not meet requirements of the Federal Government to qualify the State to receive Federal moneys to carry out the purposes of Act 414 of 1961, and that there is great need for such Federal funds to be immediately obtained, therefore, an emergency is hereby declared to exist, and this Act being necessary for the immediate preservation of public peace, health and safety, shall take effect and be in full force from and after its passage and approval.”

Acts 1971, No. 258, § 5: became law without Governor's signature, Mar. 9, 1971. Emergency clause provided: “It is found and declared by the General Assembly of Arkansas that Act 414 of 1961, and amendments thereto, does not clearly provide the State Board of Health with the authority to license, inspect and regulate Recuperation Centers, that such intermediate health care facilities are desirable and necessary, and that there is great need for such authority to be clearly and immediately established. Therefore, an emergency is hereby declared to exist, and this Act being necessary for the preservation of the public peace, health and safety, shall be in full force and effect from the date of its passage and approval.”

Acts 1975, No. 190, § 4: Feb. 18, 1975. Emergency clause provided: “It is hereby found and determined by the General Assembly that there is an urgent need in this State for outpatient surgery centers as defined herein to relieve the severe overcrowding of hospital facilities; that such centers will serve an urgent need of the citizens of this State for additional facilities where minor surgery may be performed without the necessity of entering a hospital and incurring the much higher costs of a hospital, and that this Act should be given effect immediately to permit the establishment and operation of such facilities. Therefore, an emergency is hereby declared to exist and this Act being necessary for the immediate preservation of the public peace, health and safety shall be in full force and effect from and after its passage and approval.”

Acts 1977, No. 536, § 4: Mar. 18, 1977. Emergency clause provided: “It is hereby found and determined by the General Assembly that there is an urgent need in this State for outpatient psychiatric centers as defined herein to relieve the severe overcrowding of hospital facilities; that such centers will serve an urgent need of the citizens of this State for additional facilities where psychiatric services may be provided without the necessity of entering a hospital and incurring the much higher costs of a hospital, and that this Act should be given effect immediately to permit the establishment and operation of such facilities. Therefore, an emergency is hereby declared to exist and this Act being necessary for the immediate preservation of the public peace, health and safety shall be in full force and effect from and after its passage and approval.”

Acts 1983, No. 273, § 3: Feb. 25, 1983. Emergency clause provided: “It is hereby found and determined by the General Assembly that the length and variety of billing forms now used by third-party carriers is an important source of administrative expense for hospitals and patients; that hospital cost containment is essential to the health, safety and welfare of the people and should be encouraged; and that a uniform billing form, if implemented without delay, will provide a significant savings in hospital costs in this State. Therefore an emergency is hereby declared to exist and this Act being necessary for the preservation of the public peace, health and safety shall be in full force and effect from and after its passage and approval.”

Acts 1987, No. 516, § 3: Apr. 1, 1987. Emergency clause provided: “It is hereby found and determined by the General Assembly that some hospitals around the State are discontinuing their in-patient services and as a result also are closing their emergency room services; that this Act would allow the continued operation of hospital emergency services even when the in-patient services have been discontinued; that until this Act becomes effective some portions of the State may be without adequate hospital emergency services and therefore this Act should go into effect immediately. Therefore, an emergency is hereby declared to exist and this Act being immediately necessary for the preservation of the public peace, health and safety shall be in full force and effect from and after its passage and approval.”

Acts 2019, No. 910, § 6346(b): July 1, 2019. Emergency clause provided: “It is found and determined by the General Assembly of the State of Arkansas that this act revises the duties of certain state entities; that this act establishes new departments of the state; that these revisions impact the expenses and operations of state government; and that the sections of this act other than the two uncodified sections of this act preceding the emergency clause titled ‘Funding and classification of cabinet-level department secretaries’ and ‘Transformation and Efficiencies Act transition team’ should become effective at the beginning of the fiscal year to allow for implementation of the new provisions at the beginning of the fiscal year. Therefore, an emergency is declared to exist, and Sections 1 through 6343 of this act being necessary for the preservation of the public peace, health, and safety shall become effective on July 1, 2019”.

20-9-201. Definitions.

As used in this subchapter:

1. “Administrator” means the chief administrative officer in the Division of Health Facilities Services;
2. “Alcohol and drug abuse inpatient treatment center” means a distinct unit within a hospital facility in which services are provided for the diagnosis, treatment, and rehabilitation of alcohol and drug abuse;
3. “Federal act” means the Hospital Survey and Construction Act, Pub. L. No. 79-725;
4. 1. “Hospital” means a public health center, a general, tuberculosis, mental, or chronic disease hospital, or a related facility such as a laboratory, outpatient department, nurses home or training facility, or a central service facility operated in connection with a hospital.
   2. “Hospital” does not include an establishment:
      1. Furnishing primarily domiciliary care; or
      2. Licensed or certified by the Division of Aging, Adult, and Behavioral Health Services of the Department of Human Services as an alcohol and drug abuse inpatient treatment center;
5. 1. “Institution” means a place for the diagnosis, treatment, or care of two (2) or more persons not related to the proprietor, suffering from illness, injury, or deformity, or where obstetrical care or care of the aged, blind, or disabled is rendered over a period exceeding twenty-four (24) hours.
   2. “Institution” also includes an outpatient surgery center, outpatient psychiatric center, and infirmary.
   3. “Institution” does not include an establishment:
      1. Operated by the United States Government or by any of its agencies; or
      2. Licensed or certified by the Division of Aging, Adult, and Behavioral Health Services of the Department of Human Services as an alcohol and drug abuse inpatient treatment center;
6. “Medical facility” means a diagnostic or diagnostic and treatment center, or rehabilitation facility, as these terms are defined in the federal act, and any other medical facility for which federal aid may be authorized under federal law;
7. “Nonprofit hospital” or “nonprofit medical facility” means a hospital or medical facility owned and operated by one (1) or more persons or a corporation or association, no part of the net earnings of which inures to the benefit of any shareholder or individual;
8. 1. “Outpatient psychiatric center” means a facility in which psychiatric services are offered for a period of eight (8) to sixteen (16) hours a day, and where, in the opinion of the attending psychiatrist, hospitalization, as defined in the present licensure law, is not necessary.
   2. “Outpatient psychiatric center” does not include community mental health clinics and centers as they now exist;
9. 1. “Outpatient surgery center” means a facility in which surgical services are offered that require the use of general or intravenous anesthetics and where, in the opinion of the attending physician, hospitalization, as defined in the present licensure law, is not necessary.
   2. “Outpatient surgery center” does not include:
      1. A medical office owned and operated by a physician or more than one (1) physician licensed by the Arkansas State Medical Board, if the medical office does not bill facility fees to a third party payor; or
      2. A dental office that has a Facility Permit for Moderate Sedation or a Facility Permit for General/Deep Sedation issued by the Arkansas State Board of Dental Examiners;
10. “Public health center” means a publicly owned facility for the provision of public health services and includes related facilities such as laboratories, clinics, and administrative offices operated in connection with public health centers;
11. 1. “Recuperation center” means an establishment with permanent facilities that include inpatient beds, with an organized medical staff, and with medical services including physicians' services and continuous nursing services to provide treatment for patients who are not in an acute phase of illness but who currently require primarily convalescent or restorative service that is usually post-acute hospital care of relatively short duration.
    2. “Recuperation center” does not include an establishment furnishing primarily domiciliary care; and
12. “Surgeon General” means the United States Surgeon General.

History. Acts 1961, No. 414, § 2; 1971, No. 258, § 1; 1975, No. 190, §§ 1, 2; 1977, No. 536, §§ 1, 2; 1985, No. 980, §§ 1, 2; A.S.A. 1947, § 82-328; Acts 1987, No. 143, § 1; 2011, No. 834, § 1; 2013, No. 587, § 3; 2013, No. 1107, § 18; 2017, No. 913, §§ 54, 55.

Amendments. The 2011 amendment substituted “Department of Health” for “Division of Health of the Department of Health and Human Services” in (1); inserted “a distinct unit within a hospital” in present (2); deleted former (2)(B), (3), (4), and (10)(B); added present (4)(B)(ii), (5)(C)(ii), and (8); and redesignated the remaining subdivisions accordingly.

The 2013 amendment by No. 587 redesignated former (9) as (9)(A); deleted “other than minor dental surgery” following “surgical services” in (9)(A); and added (9)(B).

The 2013 amendment by No. 1107 substituted “Division of Behavioral Health Services” for “Office of Alcohol and Drug Abuse Prevention of the Division of Behavioral Health” in (4)(B)(ii) and (5)(C)(ii).

The 2017 amendment substituted “Division of Aging, Adult, and Behavioral Health Services of the Department of Human Services” for “Division of Behavioral Health Services” in (4)(B)(ii) and (5)(C)(ii).

U.S. Code. The Hospital Survey and Construction Act, Pub. L. No. 79-725, referred to in this section has, for the most part, been eliminated from the United States Code. For remaining provisions, see 48 U.S.C. § 1666 and 42 U.S.C. § 291.

20-9-202. Penalties.

1. Any person, partnership, association, or corporation establishing, conducting, managing, or operating any institution without first obtaining a license therefor as provided or violating any provision of this subchapter or rules lawfully promulgated under this subchapter shall be guilty of a violation.
2. Upon conviction, the person shall be fined not less than twenty-five dollars ($25.00) nor more than one hundred dollars ($100) for the first offense and not less than one hundred dollars ($100) nor more than five hundred dollars ($500) for each subsequent offense.
3. Each day the institution shall operate after a first conviction shall be considered a subsequent offense.

History. Acts 1961, No. 414, § 27; A.S.A. 1947, § 82-353; Acts 2005, No. 1994, § 104; 2019, No. 315, § 1827.

Amendments. The 2019 amendment substituted “rules” for “regulations” in (a).

20-9-203. Injunction.

The State Board of Health may sue in the name of the state any person, partnership, association, or corporation in order to enjoin the establishing, conducting, managing, or operating of any institution within the meaning of this subchapter without the person's first having secured a license therefor.

History. Acts 1961, No. 414, § 26; A.S.A. 1947, § 82-352.

20-9-204. Administration by Division of Health Facilities Services.

1. There is established in the Department of Health a Division of Health Facilities Services, which shall be administered by a full-time salaried administrator under the supervision and direction of the Secretary of the Department of Health.
2. The Department of Health, through the division, is the sole agency of the state for the purpose of:
   1. Making an inventory of existing hospitals and medical facilities, surveying the need for construction of hospitals and medical facilities, and developing a program of construction as provided in this subchapter;
   2. Developing and administering a state plan for the construction of public and other nonprofit hospitals and medical facilities as provided; and
   3. Inspecting, regulating, and licensing hospitals and institutions.

History. Acts 1961, No. 414, § 3; A.S.A. 1947, § 82-329; Acts 2019, No. 910, § 4968.

Amendments. The 2019 amendment, in (a), substituted the first occurrence of “Department of Health” for “State Board of Health” and substituted “Secretary of the Department of Health” for “Director of the Department of Health”.

20-9-205. Powers and duties of State Board of Health.

1. In carrying out this subchapter, the State Board of Health is empowered and directed to:
   1. Require such reports, make such inspections and investigations, and prescribe and enforce such reasonable rules as it finds necessary to effectuate the purposes of this subchapter;
   2. Provide methods of administration of the Division of Health Facilities Services;
   3. Procure and pay for the temporary services of experts or consultants on a fee-for-service basis;
   4. Enter into agreements for the utilization of the facilities and services of other departments, agencies, and institutions, public and private;
   5. Accept on behalf of the state, and deposit with the Treasurer of State, any grant, gift, or contribution of funds made to assist in meeting the cost of carrying out the purposes of this subchapter, and expend such funds accordingly;
   6. Make an annual report to the Secretary of the Department of Health on activities and expenditures made pursuant to this subchapter;
   7. Procure the services of an attorney to assist the Department of Health in any legal work involved in carrying out the duties of the Department of Health and to pay for the services on a fee-for-service or retainer basis; and
   8. Prescribe and enforce such reasonable rules as are necessary to adopt a uniform billing form for hospitals within the state and to prescribe penalties for the failure or refusal to utilize and accept such forms. However, the form must be acceptable by Medicare and its intermediaries within the state and consistent with the form adopted at the federal level by Medicare and the National Uniform Billing Committee.
2. The Department of Health shall adopt, promulgate, and enforce such rules and standards as may be necessary for the accomplishment of the purposes of this subchapter. The rules and standards shall be modified, amended, or rescinded, from time to time, by the Department of Health as may be in the public interest.

History. Acts 1961, No. 414, §§ 4, 28; 1983, No. 273, § 1; A.S.A. 1947, §§ 82-330, 82-354; Acts 2019, No. 315, §§ 1828-1830; 2019, No. 910, § 4969.

Amendments. The 2019 amendment by No. 315 deleted “and regulations” following “rules” in (a)(1) and (a)(8); and deleted “regulations” following “rules” twice in (b).

The 2019 amendment by No. 910 deleted “and appoint an administrator and other personnel” following “administration” in (a)(2); and substituted “Secretary of the Department of Health” for “Governor” in (a)(6).

20-9-206. Construction program — Survey and planning activities.

1. The State Board of Health is empowered and directed to make an inventory of existing hospitals and medical facilities including public, nonprofit, and proprietary hospitals and medical facilities, to survey the need for construction of hospitals and medical facilities and, on the basis of the inventory and survey, to develop a program for the construction of such public and other nonprofit hospitals and medical facilities as will, in conjunction with existing facilities, afford the necessary physical facilities for furnishing adequate hospital and medical facility services to the people of the state in accordance with the regulations prescribed by the federal act.
2. The construction program shall provide, in accordance with regulations prescribed by the federal act, for adequate hospital and medical facilities for the people of the state, and insofar as possible shall provide for their distribution throughout the state in such manner as to make all types of hospital and medical facility services reasonably accessible to all persons in the state.

History. Acts 1961, No. 414, §§ 9, 10; A.S.A. 1947, §§ 82-335, 82-336.

20-9-207. Construction program — Federal funds for surveying and planning.

1. The State Board of Health may make application to the United States Surgeon General for and receive federal funds to assist in carrying out the survey and planning activities provided in § 20-9-206(a) and § 20-10-217(a).
2. The funds shall be deposited with the Treasurer of State as a trust fund designated the “Hospital and Medical Facility Survey and Planning Fund”, which shall be kept separate and apart from all public funds of the state and shall be available to the Department of Health for expenditure in carrying out the survey and planning activities provided.
3. Any funds received and not expended for such purposes shall be repaid to the United States Treasury.
4. Warrants for all payments from the fund shall bear the signature of the Secretary of the Department of Health or his or her agent.

History. Acts 1961, No. 414, § 11; A.S.A. 1947, § 82-337; Acts 2019, No. 910, § 4970.

Amendments. The 2019 amendment substituted “Secretary of the Department of Health” for “Director of the Department of Health” in (d).

20-9-208. Construction program — State plan.

1. 1. The State Board of Health shall prepare and submit to the United States Surgeon General a state plan which shall include the hospital and medical facilities construction program developed as provided in this subchapter. The plan shall provide for the establishment, administration, and operation of hospital and medical facilities construction activities in accordance with the requirements of the federal act and regulations thereunder.
   2. The state plan shall also set forth the relative need for the several projects included in the construction program determined in accordance with regulations prescribed by the federal act and provide for the construction, insofar as financial resources available for construction and for maintenance and operation permit, in the order of relative need.
2. Before the submission of the plan to the United States Surgeon General, the Department of Health shall give adequate publicity to a general description of all the provisions proposed to be included therein and hold a public hearing at which all persons or organizations with a legitimate interest in the plan may be given an opportunity to express their views.
3. After approval of the plan by the United States Surgeon General, the department shall cause to be published a general description of the provisions thereof in at least one (1) newspaper having general circulation in each county in the state and shall make the plan, or a copy thereof, available upon request to all interested persons or organizations.
4. The department shall from time to time review the construction program, submit to the United States Surgeon General any modifications of the program which it may find necessary, and may submit to the United States Surgeon General modifications of the state plan not inconsistent with the requirements of the federal act.

History. Acts 1961, No. 414, §§ 12, 14; A.S.A. 1947, §§ 82-338, 82-340.

20-9-209. Construction program — Application for funds.

1. Applications for hospital and medical facilities construction projects for which federal funds are requested shall be submitted to the State Board of Health and may be submitted by the state or any political subdivision thereof or by any public or other nonprofit agency authorized to construct and operate a hospital or a medical facility.
2. However, no application for a diagnostic or treatment center shall be approved unless the applicant is:
   1. The state, a political subdivision, or a public agency; or
   2. A person, corporation, or association which owns and operates a nonprofit hospital.
3. Each application for a construction project shall conform to federal and state requirements.
4. If, after affording reasonable opportunity for development and presentation of applications in the order of relative need, the Department of Health finds that a project application complies with subsection (a) of this section and is otherwise in conformity with the state plan, then it shall approve the application and shall recommend and forward it to the United States Surgeon General.
5. The department by rule shall provide an opportunity for fair hearing and appeal to every applicant who is dissatisfied with any action regarding an application.

History. Acts 1961, No. 414, §§ 15, 16; A.S.A. 1947, §§ 82-341, 82-342; Acts 2019, No. 315, § 1831.

Amendments. The 2019 amendment substituted “rule” for “regulation” in (e).

20-9-210. Construction program — Payment of installments.

The State Board of Health shall from time to time cause to be inspected each construction project approved by the United States Surgeon General. If the inspection warrants, the Department of Health shall certify to the United States Surgeon General that work has been performed upon the project or purchases have been made in accordance with the approved plans and specifications and that payment of an installment of federal funds is due the applicant.

History. Acts 1961, No. 414, § 17; A.S.A. 1947, § 82-343.

20-9-211. Construction program — Federal funds.

1. The State Board of Health is empowered to receive federal funds in behalf of, and transmit them to, such applicants.
2. Money received from the United States Government for a construction project shall be deposited with the Treasurer of State as a trust fund. The fund shall be separate from all public funds of the state and shall be used solely for payments due applicants for work performed or purchases made in carrying out approved projects.
3. Warrants for all payments from the fund shall bear the signature of the Secretary of the Department of Health or his or her agent.
4. The procedure provided in this section for the receipt and disbursement of such funds is not intended to deprive any applicant from receiving federal payments directly if, for any reason, the Department of Health or the Treasurer of State is not authorized to receive and transmit federal payments for certain construction projects to certain applicants.

History. Acts 1961, No. 414, § 18; A.S.A. 1947, § 82-344; Acts 2019, No. 389, § 12; 2019, No. 910, § 4971.

Amendments. The 2019 amendment by No. 389 deleted “designated the ‘Hospital and Medical Facilities Construction Fund’” following “trust fund” in the first sentence of (b).

The 2019 amendment by No. 910 substituted “Secretary of the Department of Health” for “Director of the Department of Health” in (c).

20-9-212. Minimum standards for hospitals and other institutions.

1. The State Board of Health shall require hospitals and other institutions which receive federal aid for construction under the state plan to comply with such minimum standards prescribed by the Department of Health as may be promulgated in accordance with the federal act and federal rules and regulations.
2. A hospital or institution, or the governing body thereof, shall comply with such minimum standards as may be prescribed by the department under the authority of this section even though federal aid may not be sought or received under this subchapter.

History. Acts 1961, No. 414, § 13; A.S.A. 1947, § 82-339.

20-9-213. License required — Administration by State Board of Health.

1. No hospital, recuperation center, or related institution shall be established, conducted, or maintained in this state without obtaining a license.
2. The State Board of Health may provide, by properly promulgating rules, for the issuance of a recuperation center license.
3. The Department of Health may provide, by properly promulgating rules, for the issuance of permanent type licenses, subject to revocation.

History. Acts 1961, No. 414, § 19; 1965, No. 434, § 1; 1971, No. 258, § 2; A.S.A. 1947, § 82-345; Acts 2019, No. 315, § 1832.

Amendments. The 2019 amendment deleted “and regulations” following “rules” in (b) and (c).

20-9-214. Issuance of license — Fees.

1. The State Board of Health shall issue licenses for the operation of institutions, subject to this subchapter, when the institutions are found to comply with the provisions of this subchapter and such rules as are lawfully promulgated by the Department of Health.
2. The Department of Health may levy and collect the following annual fees for issuance of an annual license to hospitals or institutions:
3. 1. Applicants for license shall file applications under oath with the Department of Health upon forms prescribed by the Department of Health and shall pay an annual license fee as set forth in subsection (b) of this section, which shall be paid into the State Treasury or refunded to the applicant if a license is denied.
   2. 1. The application shall be signed by the owner, if an individual or partnership, in the case of a corporation by two (2) of its officers, or in the case of a governmental unit by the head of the governmental department having jurisdiction over it.
      2. Applications shall set forth the full name and address of the institution for which the license is sought and such additional information as the Department of Health may require, including affirmative evidence of ability to comply with such reasonable standards and rules as may be lawfully prescribed in this subchapter.
   3. Applications for annual license renewal shall be postmarked no later than January 2 of the succeeding calendar year. License applications for existing institutions received after January 2 shall be subject to a penalty of one dollar ($1.00) per day for each day after January 2.
4. 1. Licenses issued under this section shall be effective on a calendar-year basis and shall expire on December 31 of each calendar year.
   2. A license shall be issued only for the premises and persons in the application and shall not be transferable.
   3. Licenses shall be posted in a conspicuous place on the licensed premises.
5. All fees levied and collected under this subchapter are special revenues and shall be deposited into the State Treasury, there to be credited to the Public Health Fund.
6. Subject to such rules as may be implemented by the Chief Fiscal Officer of the State, the disbursing officer for the Department of Health may transfer all unexpended funds relative to the health facility services that pertain to fees collected, as certified by the Chief Fiscal Officer of the State, to be carried forward and made available for expenditures for the same purpose for any following fiscal year.

Per facility FY '98 FY '99 (unless otherwise noted) (1) Hospitals (per bed) $ 4.00 $ 6.00 (2) Ambulatory Surgery Center 1,000.00 1,000.00 (3) Hospital-Based Recuperation Center 160.00 275.00 (4) Freestanding Recuperation Center 2,000.00 2,000.00 (5) Hospital-Based Alcohol/Drug Unit 60.00 75.00 (6) Freestanding Alcohol/Drug Unit 1,000.00 1,000.00 (7) Hospital-Based Outpatient Psychiatric Center 60.00 75.00 (8) Freestanding Outpatient Psychiatric Center 1,000.00 1,000.00 (9) Infirmary 100.00 100.00 (10) Reissuance of license due to name/address change 100.00 100.00

Click to view table.

History. Acts 1961, No. 414, § 22; 1965, No. 454, § 2; A.S.A. 1947, § 82-348; Acts 1987, No. 143, §§ 2, 4; 1997, No. 574, § 1; 2019, No. 315, §§ 1833-1835.

Amendments. The 2019 amendment substituted “rules” for “regulations” in (a); substituted “standards and rules” for “standards, rules, and regulations” in (c)(2)(B); and deleted “and regulations” following “rules” in (f).

Cross References. Health Facility Services Revolving Fund, § 19-5-1089.

20-9-215. License — Denial, suspension, and revocation.

1. The State Board of Health is empowered to deny, suspend, or revoke licenses on any of the following grounds:
   1. Violation of any of the provisions of this subchapter or the rules lawfully promulgated under this subchapter; or
   2. Permitting, aiding, or abetting the commission of any unlawful act in connection with the operation of the institutions.
2. 1. If the Department of Health determines to deny, suspend, or revoke a license, it shall send to the applicant or licensee, by certified mail, a notice setting forth the particular reasons for the determination.
   2. The denial, suspension, or revocation shall become final thirty (30) days after the mailing of the notice unless the applicant or licensee gives written notice within the thirty-day period of a desire for hearing.
3. Thereupon, the applicant or licensee shall be given a fair hearing and shall have the right to present such evidence as may be proper.
4. 1. On the basis of the evidence at the hearing, the determination involved shall be affirmed or set aside.
   2. A copy of the decision, setting forth the finding of facts and the particular grounds upon which it is based, shall be sent by certified mail to the applicant or licensee.
   3. The decision shall become final fifteen (15) days after it is mailed unless the applicant or licensee, within the fifteen-day period, appeals the decision to the court under § 20-9-216.
5. A full and complete record of all proceedings shall be kept and all testimony shall be reported, but it need not be transcribed unless the decision is appealed pursuant to § 20-9-216 or a transcript is requested by an interested party who shall pay the cost of preparing the transcript.
6. Witnesses may be subpoenaed by either party and shall be allowed fees at a rate prescribed by rules.
7. The procedure governing hearings authorized by this section shall be in accordance with rules promulgated by the department.

History. Acts 1961, No. 414, § 22; 1965, No. 454, § 2; A.S.A. 1947, § 82-348; Acts 2019, No. 315, §§ 1836-1838.

Amendments. The 2019 amendment deleted “and regulations” following “rules” in (a)(1); and substituted “rules” for “regulations” in (f) and (g).

20-9-216. License — Judicial review.

1. Any applicant or licensee who is dissatisfied with the decision of the State Board of Health or other body designated by the Department of Health or this subchapter as a result of the hearing provided in § 20-9-215 may appeal to the Pulaski County Circuit Court for judicial review of the decision within fifteen (15) days after receiving notice of the decision.
2. Thereupon, the department shall promptly certify and file in court the transcript of the hearing on which the decision is based.
3. Findings of fact by the department shall be conclusive unless contrary to law on the evidence.
4. If necessary, the court may remand the case to the department to take further evidence, and the department may thereupon make new or modified findings of fact which shall have like weight on review.
5. The court may affirm, modify, or reverse the decision of the department, and either the applicant or licensee or the department may appeal from the court's decision in the manner provided by law with regard to appeals from the court.
6. Pending final disposition of the matter, the status quo of the applicant or licensee shall be preserved.

History. Acts 1961, No. 414, § 25; A.S.A. 1947, § 82-351.

20-9-217. Alterations, additions, and new construction of facilities.

1. Before commencing alterations, additions, or new construction under this subchapter, a facility shall submit plans, including a plumbing plan that includes the plumbing as defined in § 17-38-101 and the water supply line and sewage line designs, and specifications that have been prepared by a licensed architect or professional engineer to the Department of Health with respect to compliance with the applicable codes, rules, and standards.
2. Plans and specifications as described in subsection (a) of this section shall be submitted according to procedures of the department.
3. 1. The Secretary of the Department of Health or his or her agent shall inspect each construction project approved by the United States Surgeon General.
   2. If the inspection so warrants, the secretary or his or her agent shall certify to the United States Surgeon General that work has been performed upon the project, or purchases have been made, in accordance with the approved plans and specifications, and that payment of an installment of federal funds is due the applicant.

History. Acts 1961, No. 414, § 21; A.S.A. 1947, § 82-347; Acts 1987, No. 143, § 3; 2019, No. 315, § 1839; 2019, No. 889, § 3; 2019, No. 910, § 4972.

Publisher's Notes. Acts 1987, No. 143, § 3, is also codified as § 20-10-225.

Amendments. The 2019 amendment by No. 315 substituted “rule” for “regulation” and “rules” for “regulations” in (a).

The 2019 amendment by No. 889 rewrote (a); inserted (b); and redesignated former (b) as (c)(1) and (c)(2).

The 2019 amendment by No. 910 redesignated (b) as (b)(1) and (b)(2); in (b)(1) [now (c)(1)], substituted “The Secretary” for “From time to time, the Director”; and substituted “secretary” for “director” in (b)(2) [now (c)(2)].

20-9-218. Emergency services facilities.

1. The Department of Health is empowered to license under this subchapter and §§ 20-10-213 — 20-10-231 those hospitals which have discontinued inpatient services to continue to provide emergency services.
2. The emergency services facilities shall be subject to inspection and to all other provisions of this subchapter and §§ 20-10-213 — 20-10-231 and all rules promulgated under this subchapter and §§ 20-10-213 — 20-10-231.
3. Hospital emergency services facilities licensed under this section shall not be required to obtain a certificate of need or any other permit other than that prescribed by this section.

History. Acts 1987, No. 516, § 1; 2019, No. 315, § 1840.

Publisher's Notes. Former § 20-9-218, concerning certificate of need and licensing of alcohol/drug abuse treatment centers, was repealed by Acts 1987, No. 593, § 10. The section was derived from Acts 1985, No. 980, § 3; A.S.A. 1947, § 82-345.1.

Amendments. The 2019 amendment substituted “rules” for “regulations” in (b).

20-9-219. Inspections of facilities — Definitions.

1. As used in this section:
   1. “Accrediting organization” means an organization that awards accreditation or certification to hospitals or managed care organizations and has been recognized by the Centers for Medicare & Medicaid Services for deemed status, including without limitation The Joint Commission;
   2. 1. “Hospital” means a facility used for the purpose of providing inpatient diagnostic care or treatment, including general medical care, surgical care, obstetrical care, psychiatric care, and specialized services or specialized treatment that is subject to the rules for hospitals in Arkansas.
      2. “Hospital” does not mean a facility primarily for the provision of long-term care;
   3. “Inspection” means the on-site review of the physical plant and practices as governed by the current rules of hospitals;
   4. “Investigation” means a specific inspection by the Division of Health Facilities Services related to a complaint or complaints; and
   5. “Survey” means the on-site formal review process of a hospital by the division at regular intervals to ensure compliance with applicable rules adopted by the Department of Health.
2. The department shall make such inspections and surveys as it may prescribe by rule.
3. Each hospital accredited by an accrediting organization shall be deemed by the department to be licensable without further survey by the personnel of the division if:
   1. The hospital holds current, full accreditation; and
   2. The division receives a copy of the hospital's official accreditation certificate and the complete report issued by an accrediting organization within thirty (30) days of receipt by the hospital from an accrediting organization.
4. No hospital shall be required to submit accreditation by an accrediting organization, but whenever a hospital does not submit an accreditation certificate, the personnel of the department shall conduct such surveys as are prescribed by rule.
5. 1. Nothing in this section shall affect the right of an authorized representative of the department to enter upon or into the premises of a hospital at any time to make an inspection as part of an investigation when the department does so in response to a complaint or specific identifiable information that the hospital is not meeting minimum quality standards.
   2. If the division upon review of an accrediting organization report reasonably determines that a hospital may not be meeting state licensure standards, it may perform a survey of that hospital and take such steps as are necessary to enforce the standards of the department.
6. A validation survey may be conducted on five percent (5%) of deemed hospitals during any calendar year to determine continued compliance with state rules.
7. The department shall continue to have authority over new construction, renovations, and alterations of the hospitals as set forth in the current rules.
8. All hospitals shall notify the division within thirty (30) days when there is a change in accreditation status.
9. A staff member of the division may accompany an accrediting organization team that conducts any hospital accreditation survey as an ex officio member for the purpose of observation.

History. Acts 1961, No. 414, § 21; A.S.A. 1947, § 82-347; Acts 1999, No. 506, § 2; 2007, No. 136, § 1; 2019, No. 315, §§ 1841-1845.

Publisher's Notes. Acts 1999, No. 506, § 1, provided: “Findings. The General Assembly of the State of Arkansas hereby finds and declares that the citizens of Arkansas are entitled to receive health care in hospitals which have been surveyed on a regular basis to ensure high quality care, that a hospital must undergo two (2) duplicate surveys when they decide to become accredited by the Joint Commission on Accreditation of Healthcare Organizations, and that this duplication is costly and without effect on the quality of hospital care whenever a hospital, after survey, is accredited by the Joint Commission on Accreditation of Healthcare Organizations.”

Amendments. The 2019 amendment deleted “and regulations” following “rules” in (a)(2)(A), (a)(3), and (a)(5); substituted “rule” for “regulation” in (d); and substituted “rules” for “regulations” in (f) and (g).

20-9-220. Annual report.

The Department of Health shall make an annual report of its activities and operations under this subchapter to the Governor and shall make such information available to the General Assembly as may be requested.

History. Acts 1961, No. 414, § 24; A.S.A. 1947, § 82-350.

20-9-221. Information confidential.

1. Information received by the Department of Health through inspection, or otherwise, authorized under this subchapter, shall not be disclosed publicly in such manner as to identify individuals or institutions except in a proceeding involving the question of licensing or revocation of a license.
2. 1. However, in the case of a specific written request by the deputy director of the appropriate division as determined by the Secretary of the Department of Human Services for information concerning a certain nursing home, information obtained during recent inspections of the home may be supplied in writing to the deputy director.
   2. This exception applies only to homes providing care for recipients of public welfare and is not to be construed as permitting the exchange of such information on all homes in the state but is specifically limited to those for which the deputy director of the appropriate division as determined by the secretary has specific complaints.
   3. These complaints shall be forwarded to the department along with the request for information from the deputy director.
   4. Information received by the deputy director in the manner prescribed by this section shall not be disclosed.

History. Acts 1961, No. 414, § 23; 1965, No. 434, § 2; A.S.A. 1947, § 82-349; Acts 2019, No. 910, § 5174.

Amendments. The 2019 amendment substituted “Secretary of the Department of Human Services” for “Director of the Department of Human Services” in (b)(1); and substituted “secretary” for “director” in (b)(2).

20-9-222. Certification fee.

The Department of Health may levy and collect a fee for the issuance of an annual certification to child health management services clinics. The certification fee for a child health management services clinic shall be an annual fee of one thousand dollars ($1,000).

History. Acts 1997, No. 574, § 4.

A.C.R.C. Notes. References to “this subchapter” in §§ 20-9-201 — 20-9-221 may not apply to this section which was enacted subsequently.

References to “this chapter” in subchapter 1, §§ 20-9-201 — 20-9-221 and subchapters 3 and 5-9 may not apply to this section which was enacted subsequently.

Cross References. Health Facility Services Revolving Fund, § 19-5-1089.

20-9-223. Medical office licensure.

A medical office owned and operated by a physician or more than one (1) physician may apply for licensure by the State Board of Health as an outpatient surgery center.

History. Acts 2013, No. 587, § 4.

Subchapter 3 — Hospitals, Clinics, Etc. — Miscellaneous Provisions

Cross References. Good Samaritan law, § 17-95-101.

Hospital's duty to report physician misconduct, § 17-95-104.

Reproductive health information, § 20-16-401 et seq.

Effective Dates. Acts 1969, No. 198, § 5: Mar. 7, 1969. Emergency clause provided: “It being immediately necessary for the furtherance of medical research and education and the protection of the public peace, health and safety, an emergency is hereby declared to exist, by reason whereof this Act shall take effect and be in full force from and after its passage and approval.”

Acts 1975 (Extended Sess., 1976), No. 1231, § 3: Feb. 16, 1976. Emergency clause provided: “It is hereby found and determined by the General Assembly that the operation of public supported hospitals which serve the public is of great interest and concern to the citizens of the State; that since the operation and financial condition of such hospitals is of serious concern to the public, it is appropriate that such hospitals be required to publish an annual financial report, and that this Act should be given effect immediately in order to assure the publication of such reports at the earliest possible date. Therefore, an emergency is hereby declared to exist and this Act being necessary for the immediate preservation of the public peace, health and safety shall be in full force and effect from and after its passage and approval.”

Acts 1983, No. 509, § 4: Mar. 17, 1983. Emergency clause provided: “It is hereby found and determined by the General Assembly that there exists in the State facilities which are primarily abortion clinics; that the wilful termination or abortion of the pregnancy of a woman who is known to be pregnant is a hazardous procedure; that under present laws, such abortion clinics are not adequately supervised and regulated; that this Act is designed to provide for such supervision and regulation and should be given effect immediately. Therefore, an emergency is hereby declared to exist and this Act being necessary for the preservation of the public peace, health and safety shall be in full force and effect from and after its passage and approval.”

Acts 1995, No. 1358, § 8: became law without the Governor's signature. Noted Apr. 17, 1995. Emergency clause provided: “It is hereby found and determined by the General Assembly of the State of Arkansas that there is an immediate and urgent need to protect the lives, health, and welfare of the people of Arkansas during medical emergencies which require these provisions to be authorized immediately. Therefore, an emergency is hereby declared to exist and this act being necessary for the immediate preservation of the public peace, health, and safety, shall be in full force and effect from and after its passage and approval.”

Acts 2001, No. 451, § 5: June 1, 2001. Emergency clause provided: “It is found and determined by the General Assembly of the State of Arkansas that numerous health care workers are presently exposed through the use of needles to bloodborne pathogens, serious viruses and diseases, including the human immunodeficiency virus (HIV), hepatitis B, and hepatitis C, and other potentially fatal diseases. The needleless systems or sharps with engineered sharps injury protections required under this act will provide significant protections to the lives and health of health care workers. Therefore, an emergency is declared to exist and this act being immediately necessary for the preservation of the public peace, health and safety shall become effective on June 1, 2001.”

Acts 2006 (1st Ex. Sess.), No. 4, § 11: Apr. 7, 2006. Emergency clause provided: “It is found and determined by the General Assembly of the State of Arkansas that the need to register sex offenders and update the registration files of sex offenders is necessary to ensure the safety of the citizens of the State of Arkansas; that the provisions of this act will improve the process of registering sex offenders and updating the registration files of sex offenders; and that this act is immediately necessary because of the public risk posed by sex offenders. Therefore, an emergency is declared to exist and this act being immediately necessary for the preservation of the public peace, health, and safety shall become effective on: (1) The date of its approval by the Governor; (2) If the bill is neither approved nor vetoed by the Governor, the expiration of the period of time during which the Governor may veto the bill; or (3) If the bill is vetoed by the Governor and the veto is overridden, the date the last house overrides the veto.”

Acts 2011, No. 1176, § 2: Jan. 1, 2012.

Acts 2019, No. 910, § 6346(b): July 1, 2019. Emergency clause provided: “It is found and determined by the General Assembly of the State of Arkansas that this act revises the duties of certain state entities; that this act establishes new departments of the state; that these revisions impact the expenses and operations of state government; and that the sections of this act other than the two uncodified sections of this act preceding the emergency clause titled ‘Funding and classification of cabinet-level department secretaries’ and ‘Transformation and Efficiencies Act transition team’ should become effective at the beginning of the fiscal year to allow for implementation of the new provisions at the beginning of the fiscal year. Therefore, an emergency is declared to exist, and Sections 1 through 6343 of this act being necessary for the preservation of the public peace, health, and safety shall become effective on July 1, 2019”.

20-9-301. Posting of room rates.

1. All public and private hospitals located and operated in this state shall post in some conspicuous place in each patient's room the daily room rates for both a private and a semiprivate room.
2. Any hospital or person violating subsection (a) of this section shall be guilty of a violation and upon conviction shall be subject to a fine of not less than ten dollars ($10.00) nor more than fifty dollars ($50.00) for each violation.

History. Acts 1967, No. 91, §§ 1, 2; A.S.A. 1947, §§ 82-355, 82-356; Acts 2005, No. 1994, § 105.

20-9-302. Abortion clinics, health centers, etc.

1. 1. A clinic, health center, or other facility in which the pregnancies of ten (10) or more women known to be pregnant are willfully terminated or aborted in any month, including nonsurgical abortions, shall be licensed by the Department of Health.
   2. 1. The department shall inspect a clinic, health center, or other facility at least annually, and inspections shall include without limitation:
         1. The facilities, equipment, and conditions of a clinic, health center, or other facility; and
         2. A representative sample of procedures, techniques, medical records, informed consent signatures, and parental consent signatures.
      2. An inspector shall arrive at the clinic, health center, or other facility unannounced and without prior notice.
2. The department shall:
   1. Adopt appropriate rules, regarding without limitation the facilities, equipment, procedures, techniques, medical records, informed consent signatures, parental consent signatures, and conditions of a clinic, health center, or other facility subject to the provisions of this section to assure at a minimum that:
      1. The facilities, equipment, procedures, techniques, and conditions of the clinic, health center, or other facility are aseptic and do not constitute a health hazard;
      2. The medical records, informed consent signatures, and parental consent signatures meet statutory requirements;
      3. The clinic, health center, or other facility provides to the patient on a twenty-four-hour basis telephone consultation with a registered nurse or physician associated with the clinic, health center, or other facility;
      4. The clinic, health center, or other facility has a written procedure for emergency transfer of a patient to an acute care facility, including a medical record form that contains information required for an emergency transfer to an acute care facility;
      5. The clinic, health center, or other facility is within thirty (30) miles of a hospital that provides gynecological or surgical services;
      6. The clinic, health center, or other facility has drugs, oxygen, intravenous fluids, and other emergency equipment on-site and readily available to stabilize a patient if necessary; and
      7. All staff at the clinic, health center, or other facility have documented current competency in cardiopulmonary resuscitation;
   2. Levy and collect an annual fee of five hundred dollars ($500) per facility for issuance of a permanent license to an abortion facility; and
   3. 1. Deny, suspend, or revoke licenses on any of the following grounds:
         1. The violation of any provision of law or rule; or
         2. The permitting, aiding, or abetting of the commission of any unlawful act in connection with the operation of the institutions.
      2. 1. If the department determines to deny, suspend, or revoke a license, the department shall send to the applicant or licensee, by certified mail, a notice setting forth the particular reasons for the determination.
         2. The denial, suspension, or revocation shall become final thirty (30) days after the mailing of the notice unless the applicant or licensee gives written notice within the thirty-day period of a desire for hearing.
         3. 1. The department shall issue an immediate suspension of a license if an investigation or survey determines that:
               1. The applicant or licensee is in violation of any state law or rule; and
               2. The violation or violations pose an imminent threat to the health, welfare, or safety of a patient.
            2. 1. The department shall give the applicant or licensee written notice of the immediate suspension.
               2. The suspension of the license is effective upon the receipt of the written notice.
         4. The denial, suspension, or revocation order shall remain in effect until all violations have been corrected.
      3. The applicant or licensee shall:
         1. Be given a fair hearing; and
         2. Have the right to present evidence as may be proper.
      4. 1. On the basis of the evidence at the hearing, the determination involved shall be affirmed or set aside.
         2. A copy of the decision, setting forth the finding of facts and the particular grounds upon which it is based, shall be sent by certified mail to the applicant or licensee.
         3. The decision shall become final fifteen (15) days after it is mailed unless the applicant or licensee, within the fifteen-day period, appeals the decision to the court.
      5. A full and complete record of all proceedings shall be kept and all testimony shall be reported, but it need not be transcribed unless the decision is appealed or a transcript is requested by an interested party who shall pay the cost of preparing the transcript.
      6. Witnesses may be subpoenaed by either party and shall be allowed fees at a rate prescribed by rule.
      7. The procedure governing hearings authorized by this section shall be in accordance with rules promulgated by the department.
3. 1. Applicants for a license shall file applications upon such forms as are prescribed by the department.
   2. A license shall be issued only for the premises and persons in the application and shall not be transferable.
4. 1. A license shall be effective on a calendar-year basis and shall expire on December 31 of each calendar year.
   2. Applications for annual license renewal shall be postmarked no later than January 2 of the succeeding calendar year.
   3. License applications for existing institutions received after that date shall be subject to a penalty of two dollars ($2.00) per day for each day after January 2.
5. Subject to such rules as may be implemented by the Chief Fiscal Officer of the State, the disbursing officer for the department may transfer all unexpended funds relative to the abortion clinics that pertain to fees collected, as certified by the Chief Fiscal Officer of the State, to be carried forward and made available for expenditures for the same purpose for any following fiscal year.
6. All fees levied and collected under this section are special revenues and shall be deposited into the State Treasury to be credited to the Public Health Fund.

History. Acts 1983, No. 509, §§ 1, 2; A.S.A. 1947, §§ 82-367, 82-368; Acts 1987, No. 144, § 1; 2011, No. 1176, § 1; 2017, No. 383, § 2; 2019, No. 315, §§ 1846, 1847; 2019, No. 801, § 1.

A.C.R.C. Notes. Acts 2019, No. 801, § 13, provided: “Savings clause.

“(a) If a court order holds that any amendment to the Arkansas Code made by this act is invalid or unenforceable, then the relevant portion of the Arkansas Code in effect prior to the enactment of this act shall remain in full force and effect from and after the effective date of this act [July 24, 2019], notwithstanding the amendment made by this act.

“(b) If a court order holding that an amendment to the Arkansas Code made by this act or a provision of this act is invalid or unenforceable expires or is reversed, vacated, or set aside, then the provision of the Arkansas Code as amended by this act or any provision of this act shall be effective immediately upon the expiration, reversal, vacatur, or setting aside of the court order.”

Amendments. The 2011 amendment subdivided the section; rewrote (a)(1); and substituted “department” for “division” in (a)(2).

The 2017 amendment substituted “in any” for “each” in (a)(1); rewrote (a)(2); rewrote former (b) as the introductory language of (b) and (b)(1); added (b)(2) and (b)(3); deleted former (c) and redesignated the remaining subsections accordingly; and deleted “there” preceding “to be credited” in (f).

The 2019 amendment by No. 315 substituted “state law or rule” for “state law, rule, or regulation” in (b)(3)(B)(iii) (a)(1) ; and deleted “and regulations” following “rules” in (e).

The 2019 amendment by No. 801 substituted “a clinic, health center, or other facility” for “clinics, health centers, and other facilities” in the introductory language of (b)(1); in (b)(1)(A), inserted “of the clinic, health center, or other facility” and deleted “and” at the end; and added (b)(1)(C) through (b)(1)(G).

Cross References. Disposition of fetus or fetal material resulting from an abortion, §§ 20-17-801, 20-17-802.

Regulation of abortions, §§ 5-61-101, 20-16-601.

20-9-303. [Repealed.]

Publisher's Notes. This section, concerning medical treatment for sexual assault victims, was repealed by Acts 2001, No. 993, § 6. The section was derived from Acts 1985, No. 400, §§ 1, 2; 1985, No. 838, §§ 1, 2; A.S.A. 1947, §§ 41-1828, 41-1829; Acts 1991, No. 612, § 4; 1993, No. 403, § 12.

20-9-304. Use of records for medical research.

1. All information, interviews, reports, statements, memoranda, or other data of the State Board of Health, the Arkansas Medical Society, allied medical societies, or in-hospital staff committees of licensed hospitals, but not the original medical records pertaining to the patients, used in the course of medical studies for the purpose of reducing morbidity or mortality, as provided in this section, shall be strictly confidential and shall be used only for medical research.
2. Any authorized person, hospital, sanatorium, nursing home, rest home, or other organization may provide information, interviews, reports, statements, memoranda, or other data relating to the condition and treatment of any person to any of the following for use in the course of studies for the purpose of reducing morbidity or mortality:
   1. The board;
   2. The Arkansas Medical Society or any committee or allied society thereof;
   3. Any other national medical organization approved by the board or any committee or allied medical society therein; or
   4. Any in-hospital staff committee of licensed hospitals.
3. No liability for damages or other relief shall arise or be enforced against any authorized person, institution, or organization for:
   1. Providing the information or material;
   2. Releasing or publishing the findings and conclusions of the groups to advance medical research and medical education; or
   3. Releasing or publishing generally a summary of the studies.
4. 1. The identity of the person whose condition or treatment has been studied shall be confidential and shall not be revealed under any circumstances.
   2. Any information furnished shall not contain the name of the person upon whom information is furnished and shall not violate the confidential relationship of patient and doctor.
5. 1. Except for the original medical records pertaining to the patient, all information, interviews, reports, statements, memoranda, or other data furnished under this section and any findings or conclusions resulting from the studies are declared to be privileged communications that may not be used or offered or received in evidence in any legal proceeding of any kind.
   2. Except for the original medical records pertaining to the patient, any attempt to use or offer the information, interviews, reports, statements, memoranda or other data, findings, or conclusions, or any part thereof, shall constitute prejudicial error in any proceeding unless waived by the interested parties.
6. 1. Physicians and others appointed to hospital utilization review committees for the purpose of determining the optimum use of hospital services shall be immune from liability with respect to decisions made as to utilization and actions thereunder so long as the physicians or others act in good faith.
   2. However, nothing in this section shall be construed to relieve any patient's personal physician of any liability which he or she may have in connection with the treatment of the patient.
7. Nothing in this section shall be construed to prevent any court from subpoenaing the medical records of any patient.

History. Acts 1969, No. 198, §§ 1, 2; A.S.A. 1947, §§ 82-357, 82-358.

20-9-305. Annual reports — Nonprofit hospitals.

1. 1. Any nonprofit hospital association or corporation organized under the laws of this state that operates and maintains a hospital facility in this state primarily for providing hospital services for the employees of any corporation or company engaged in interstate commerce shall file annually with the Secretary of the Department of Finance and Administration a detailed report of income, fees, charges, and contributions from all sources received by it during the year, together with the expenses and disbursements of the corporation or association during the year.
   2. The report shall be filed on or before April 1 in each year.
   3. A copy of the report shall be furnished to each member of the hospital association or corporation upon the request of any member.
2. Any nonprofit hospital association or corporation failing or refusing to file the report as required in subsection (a) of this section or which fails or refuses to furnish any member a copy of the report or statement upon request shall be guilty of a violation and shall be subject to a fine of ten dollars ($10.00) for each day that the violation continues.
3. 1. The provisions of this section shall not apply to any nonprofit hospital association or corporation that operates and maintains a hospital facility in any county of this state having a population of not less than twenty-five thousand six hundred (25,600) nor more than twenty-five thousand seven hundred (25,700), according to the 1970 Federal Decennial Census.
   2. The provisions of this section shall not be applicable with respect to any nonprofit hospital associations or corporations that operate and maintain a hospital facility in any county of this state having a population of not less than forty-seven thousand (47,000) nor more than fifty thousand (50,000), according to the 1970 Federal Decennial Census.

History. Acts 1971, No. 452, §§ 1-3; A.S.A. 1947, §§ 82-360 — 82-362; Acts 2005, No. 1994, § 106; 2019, No. 910, § 3481.

Amendments. The 2019 amendment substituted “Secretary of the Department of Finance and Administration” for “Director of the Department of Finance and Administration” in (a)(1).

20-9-306. Annual reports — Public-supported hospitals.

1. All public-supported hospitals in the State of Arkansas shall publish an annual report including financial statements showing profits, expenditures, and operating costs.
2. Every such hospital shall publish its annual report in a newspaper of general circulation within the county where it is located.

History. Acts 1975 (Extended Sess., 1976), No. 1231, §§ 1, 2; A.S.A. 1947, §§ 82-365, 82-366; reen. Acts 1987, No. 1016, §§ 1, 2.

A.C.R.C. Notes. This section was reenacted by Acts 1987, No. 1016, §§ 1, 2. Acts 1987, No. 834, provided that 1987 legislation reenacting acts passed in the 1976 Extended Session should not repeal any other 1987 legislation and that such other legislation would be controlling in the event of conflict.

20-9-307. Itemized statement for services, drugs, and supplies.

1. 1. Upon the patient's request at the time of discharge of each patient or at the time of billing the patient or the insurance company for the patient or at the time of billing the patient or the insurance company for the hospital services, drugs, and supplies, each hospital in the state, except those operated by the State of Arkansas, shall furnish to the patient and to the insurance company an itemized listing of all services, drugs, and supplies to be billed to that person while a patient in the hospital.
   2. The itemized statement shall be furnished to the patient and the insurance company no later than thirty (30) days after discharge of the patient.
   3. In addition, at the time of discharge each patient discharged from a hospital in this state shall be advised in writing of his or her right to receive the itemized statement for services, drugs, and supplies required by this section.
   4. The State Board of Health shall adopt rules specifying the items to be included and the manner in which they shall be presented on itemized statements as required in this section.
2. The administrator or the agent of any hospital who fails or refuses to provide the itemized statement upon request as required in this section or fails or refuses at the time of discharge of any patient to advise the patient of his or her right to receive the itemized statement provided in this section shall be guilty of a violation and upon conviction shall be subject to a fine of not less than fifty dollars ($50.00) nor more than one hundred fifty dollars ($150) for each violation.

History. Acts 1987, No. 348, §§ 1-3; Acts 2005, No. 1994, § 107.

20-9-308. Advice by hospital employees to reviewing committees.

When requested, any physician, surgeon, hospital administrator, nurse, technologist, and any other person engaged in work in or about a licensed hospital and having any information or knowledge relating to the medical and hospital care provided in the hospital or to the efficient use of the hospital facilities shall be obligated to advise committees reviewing such matters with respect to all the facts or information possessed by the individual with reference to such care or use.

History. Acts 1977, No. 445, § 2; A.S.A. 1947, § 19-4724.

20-9-309. Emergency Medical Care Act — Definitions.

1. This section may be cited as the “Emergency Medical Care Act”.
2. Because of the need for rapid assessment and care, in order to protect the life and health of the people of Arkansas during a medical emergency, it is found and declared necessary:
   1. To establish a definition for emergency medical care;
   2. To ensure that emergency medical care is provided in a timely manner by licensed and qualified personnel at a hospital's emergency department; and
   3. To ensure that emergency medical care is not delayed or denied based on:
      1. A person's ability to pay for expenses incurred during a medical emergency; or
      2. Prospective authorization of treatment by an insurance company, health maintenance organization, hospital medical service corporation, health benefit plan, or any other insurer.
3. As used in this section:
   1. “Emergency medical care” means healthcare services provided in a hospital emergency facility to evaluate and treat medical conditions of a recent onset and severity, including, but not limited to, severe pain that would lead a prudent lay person, possessing an average knowledge of medicine and health, to believe that his or her condition, sickness, or injury is of such a nature that failure to get immediate medical care could result in:
      1. Placing the patient's health in serious jeopardy;
      2. Serious impairment to bodily functions; or
      3. Serious dysfunction of any bodily organ or part;
   2. “Emergency medical provider” means a hospital licensed by the Department of Health, hospital-based services or a physician licensed by the Arkansas State Medical Board who provides emergency medical care; and
   3. “Prospective authorization” means contacting any insurer, health maintenance organization, hospital medical service corporation, or health benefit plan that is not physically present in the hospital's emergency department at the time the patient presents for emergency medical care for approval or authorization to evaluate and treat the patient.
4. 1. Once a person qualifying for emergency medical care presents to an emergency department, that person shall be evaluated by medical personnel. This evaluation may include diagnostic testing to assess the extent of the condition, sickness, or injury and radiographic procedures and interpretations by a radiologist.
   2. Appropriate intervention may be initiated by medical personnel to stabilize any condition presenting under this section before receiving authorization for the treatment by an insurer, health maintenance organization, hospital medical service corporation, or health benefit plan.

History. Acts 1995, No. 1358, §§ 1-4.

20-9-310. No liability for furnishing medical records or accessing information pursuant to subpoena or other legal obligation or authority.

Notwithstanding any other law to the contrary, no person or medical facility serving as a custodian of health or medical records shall be subject to any civil or criminal liability for:

1. Providing access to or producing copies of the records pursuant to a subpoena issued by any board, agency, commission, prosecuting attorney, or grand jury;
2. Providing access to or producing a copy of the health or medical records requested by a clerk of a court, the Division of Correction, the Division of Community Correction, the Arkansas State Hospital, the Department of Health, the Department of Human Services, or a local law enforcement agency under the Sex Offender Registration Act of 1997, § 12-12-901 et seq.; or
3. Requesting or accessing information under § 17-80-116.

History. Acts 1999, No. 1536, § 12; 2006 (1st Ex. Sess.), No. 4, § 10; 2019, No. 910, § 995.

Amendments. The 2019 amendment substituted “Division of Correction” for “Department of Correction” and “Division of Community Correction” for “Department of Community Correction” in (2).

20-9-311. Findings — Definitions.

1. The General Assembly finds that:
   1. Numerous workers who are occupationally exposed to blood-borne pathogens have contracted fatal and other serious viruses and diseases, including the human immunodeficiency virus (HIV), hepatitis B, and hepatitis C, from exposure to blood and other potentially infectious materials in their workplaces;
   2. In 1991, the United States Occupational Safety and Health Administration issued a standard regulating occupational exposure to blood-borne pathogens including the human immunodeficiency virus (HIV), the hepatitis B virus, and the hepatitis C virus;
   3. Compliance with the blood-borne pathogens standard has significantly reduced the risk that workers will contract a blood-borne disease in the course of their work;
   4. Nevertheless, occupational exposure to blood-borne pathogens from accidental sharps injuries in healthcare settings continues to be a serious problem;
   5. In March 2000, the Centers for Disease Control and Prevention estimated that more than three hundred eighty thousand (380,000) percutaneous injuries from contaminated sharps occur annually among healthcare workers in United States hospital settings;
   6. Estimates for all healthcare settings are that six hundred thousand (600,000) to eight hundred thousand (800,000) needlestick and other percutaneous injuries occur among healthcare workers annually involving sharps contaminated with blood-borne pathogens such as the human immunodeficiency virus (HIV), hepatitis B, or hepatitis C;
   7. Since publication of the blood-borne pathogens standard in 1991, there has been a substantial increase in the number and assortment of effective engineering controls available to employers;
   8. There is now a large body of research and data concerning the effectiveness of newer engineering controls, including safer medical devices;
   9. Numerous studies have demonstrated that the use of safer medical devices such as needle-less systems and sharps with engineered sharps injury protections can be extremely effective in reducing accidental sharps injuries when they are part of an overall blood-borne pathogens risk-reduction program;
   10. In March 2000, the Centers for Disease Control and Prevention estimated that sixty-two percent (62%) to eighty-eight percent (88%) of sharps injuries potentially can be prevented by the use of safer medical devices depending on the type of device used and the procedure involved;
   11. Training and education in the use of safer medical devices and safer work practices are significant elements in the prevention of percutaneous exposure incidents;
   12. Staff involvement in the device selection and evaluation process is also an important element in achieving a reduction in sharps injuries, particularly as newer, safer devices are introduced into work settings;
   13. The United States Congress has recognized the seriousness of the dangers of sharps injuries by passing the Needlestick Safety and Prevention Act, Pub. L. No. 106-430; and
   14. Considerable time will lapse before federal regulations are published, hospitals prepare implementation plans, federal agencies review implementation plans, and hospitals begin implementation.
2. As used in this section:
   1. “High-risk area” means the emergency department, operating rooms, and intensive care units in acute care hospitals;
   2. “Needleless systems” means devices that do not use needles for:
      1. The collection of bodily fluids or withdrawal of bodily fluids after initial venous or arterial access is established;
      2. The administration of medication or fluids; or
      3. Any other procedure involving the potential for occupational exposure to blood-borne pathogens due to percutaneous injuries from contaminated sharps;
   3. “Sharps” means a needle used to withdraw bodily fluids, access a vein or artery, or administer medication or other fluids; and
   4. “Sharps with engineered sharps injury protections” means a nonneedle sharp or a needle device used for withdrawing bodily fluids, accessing a vein or artery, or administering medications or other fluids with a built-in safety feature or mechanism that effectively reduces the risk of an exposure incident.
3. Immediately after June 1, 2001, hospitals shall begin purchasing needleless systems or sharps with engineered sharps injury protections, or both, for use in high-risk areas, with the goal of ensuring that within eighteen (18) months after June 1, 2001, all high-risk areas shall be supplied exclusively with needleless systems or sharps with engineered sharps injury protections, or both.
4. Any prefilled syringe approved by the United States Food and Drug Administration shall not be subject to the provisions of this section until July 2005.

History. Acts 2001, No. 451, §§ 1-4.

Subchapter 4 — Freestanding Birthing Centers

A.C.R.C. Notes. References to “this chapter” in subchapters 1-3 or 5-9 may not apply to this subchapter which was enacted subsequently.

Publisher's Notes. Former subchapter 4, dealing with the State Medical Services Advisory Commission, was repealed by Acts 1989, No. 536, § 7. The subchapter was derived from the following sources:

20-9-401. Acts 1965, No. 372, § 1; A.S.A. 1947, § 7-601.

20-9-402. Acts 1965, No. 372, § 2; A.S.A. 1947, § 7-602.

20-9-403. Acts 1965, No. 372, § 3; A.S.A. 1947, § 7-603.

20-9-404. Acts 1965, No. 372, § 4; A.S.A. 1947, § 7-604.

20-9-401. Definitions.

As used in this subchapter:

1. “Freestanding birthing center” means any facility, institution, or place, which is not an ambulatory surgical center or a hospital or in a hospital, organized to provide family-centered maternity care for women and childbearing families in which births are planned to occur in a homelike atmosphere away from the mothers' usual residences following a low-risk pregnancy; and
2. “Low-risk pregnancy” means a normal uncomplicated pregnancy as determined by a generally accepted course of prenatal care and expectation of a normal uncomplicated birth as defined by reasonable and generally accepted criteria of maternal and fetal health.

History. Acts 1997, No. 891, § 1.

20-9-402. Deliveries — Dismissal of mother and infant.

1. A freestanding birthing center shall have a qualified medical director, and deliveries shall be performed by a qualified physician or by a certified nurse midwife in accordance with an arrangement with a physician as required by § 17-87-101 et seq.
2. A mother and her infant shall be dismissed from a freestanding birthing center within twenty-four (24) hours of the admission.

History. Acts 1997, No. 891, § 2.

20-9-403. Regulation by Department of Health.

1. The Department of Health shall establish and enforce rules:
   1. Setting minimum standards for the construction, maintenance, and operation of a freestanding birthing center; and
   2. Setting qualifications for medical directors of freestanding birthing centers and for physicians who will perform deliveries in freestanding birthing centers.
2. A freestanding birthing center shall meet life safety code and construction standards developed by the National Fire Protection Association and shall comply with rules developed by the department.

History. Acts 1997, No. 891, § 3; 2019, No. 315, § 1848.

Amendments. The 2019 amendment substituted “rules” for “regulations” in the introductory language of (a) and in (b).

20-9-404. License fee.

The Department of Health may levy and collect a fee for the issuance of an annual license to a freestanding birthing center. The license fee for a freestanding birthing center shall be an annual fee of one thousand dollars ($1,000).

History. Acts 1997, No. 891, § 5.

20-9-405. Practice of midwifery.

Nothing in this subchapter shall be construed to prohibit the lawful practice of lay midwifery in any location under the Licensed Lay Midwife Act, § 17-85-101 et seq.

History. Acts 1997, No. 891, § 4.

Subchapter 5 — Peer Review Committees

Effective Dates. Acts 1975, No. 191, § 6: Feb. 18, 1975. Emergency clause provided: “It is hereby found and determined by the General Assembly that there is currently no law which grants specific immunity to the members of peer review committees as defined in Section 1 hereof and functioning in the State of Arkansas; that it is essential to the proper and effective operations of such committees that immunity be granted members of such committees for acts of the members performed within the scope of the functions of the committee and without malice or fraud; that this Act is designed to grant such immunity only in actions by providers of health services against such committees or the members thereof; that it is urgent that this Act be given effect at the earliest possible date to grant this limited immunity to peer review committees in order that they may perform their functions and duties more effectively. Therefore, an emergency is hereby declared to exist and this Act being necessary for the immediate preservation of the public peace, health and safety shall be in full force and effect from and after its passage and approval.”

20-9-501. Definition.

As used in this subchapter, “peer review committee” or “committee” means a committee of a hospital medical staff, a committee of a state or local professional association, or a committee organized by and operating pursuant to a written plan or policy under the auspices of a professional corporation or a professional limited liability company whose members are licensed to practice medicine in this state that is formed to:

1. Evaluate and improve the quality of health care rendered by providers of health services; or
2. Determine that:
   1. Health services rendered were professionally indicated or were performed in compliance with the applicable standard of care; or
   2. The cost of health care rendered was considered reasonable by the providers of professional health services in the area.

History. Acts 1975, No. 191, § 1; A.S.A. 1947, § 82-3201; Acts 1999, No. 1536, § 9; 2013, No. 441, § 1.

Amendments. The 2013 amendment inserted “or a committee organized by and operating … licensed to practice medicine in this state” in the introductory paragraph.

20-9-502. Liability of committee members.

1. There shall be no monetary liability on the part of, and no cause of action for damages shall arise against, any member of a peer review committee for any act or proceeding undertaken or performed within the scope of the functions of the committee if the committee member acts without malice or fraud.
2. This subchapter shall not be construed to confer immunity from liability on any professional association or upon any health professional while performing services other than as a member of a peer review committee.

History. Acts 1975, No. 191, §§ 2, 3; A.S.A. 1947, §§ 82-3202, 82-3203.

20-9-503. Proceeding and records confidential — Exception.

1. 1. The proceedings and records of a peer review committee shall not be subject to discovery or introduction into evidence in any civil action against a provider of professional health services arising out of the matters which are subject to evaluation and review by the committee.
   2. No person who was in attendance at a meeting of the committee shall be permitted or required to testify in any such civil action as to any evidence or other matters produced or presented during the proceedings of the committee or as to any findings, recommendations, evaluations, opinions, or other actions of the committee or any members thereof.
2. 1. However, information, documents, or records otherwise available from original sources are not to be construed as immune from discovery or use in any such action merely because they were presented during the proceedings of the committee.
   2. Nor shall any person who testifies before the committee or who is a member of the committee be prevented from testifying as to matters within his or her knowledge, but the witness shall not be asked about his or her testimony before the committee or about opinions formed by him or her as a result of the committee hearings.
3. The submission of the peer review proceedings, minutes, records, reports, and communications to a hospital governing board or physician group peer review committee as defined under § 20-9-501 shall not operate as a waiver of the privilege.

History. Acts 1975, No. 191, § 4; A.S.A. 1947, § 82-3204; Acts 1999, No. 1536, § 10; 2013, No. 441, § 2.

Amendments. The 2013 amendment inserted “or physician group peer review committee as defined under § 20-9-501” in (c).

Subchapter 6 — Consent to Treatment

Effective Dates. Acts 1973, No. 328, § 5: Mar. 14, 1973. Emergency clause provided: “It is hereby found and determined by the General Assembly that at the present time a minor will not be allowed to undergo certain medical or surgical procedures without the consent of a parent or guardian and that the law is unclear as to the consent required before surgical or medical procedures can be performed on other individuals not capable of consent due to injury or incompetence, and that this present situation greatly impairs medical treatment and frequently endangers the life and limb of the patient when consent for medical and surgical treatment is unavailable and that in order to alleviate this problem it is necessary for this Act to become effective immediately. Therefore, an emergency is hereby declared to exist and this Act being necessary for the immediate preservation of the public peace, health and safety shall be in full force and effect from and after its passage and approval.”

Acts 1977, No. 805, § 5: Mar. 28, 1977. Emergency clause provided: “It is hereby found and determined by the General Assembly that there is confusion in the minds of many people as to when consent to emergency medical treatment shall be implied under the law even though consent is apparently refused or withheld by one authorized to consent; that where a minor, adult of unsound mind, pregnant female or parent of a minor child is in dire need of emergency medical treatment, the State of Arkansas must consent to such treatment for the good of all when consent is withheld by one empowered or capable of consent; and that this Act should be given effect immediately to accomplish these purposes. Therefore, an emergency is hereby declared to exist and this Act being necessary for the immediate preservation of the public peace, health, and safety shall be in full force and effect from and after its passage and approval.”

Acts 1981, No. 511, § 5: Mar. 16, 1981. Emergency clause provided: “It is hereby found and determined by the General Assembly that there is confusion in the minds of many people as to the circumstances in which a parent can consent for its child, natural, adopted, stepchild or foster child, and that a married person or aged person may not be allowed to undergo certain medical or surgical procedures without appropriate consent and that the law is unclear as to the consent required before surgical or medical procedures can be performed, and that this present situation greatly impairs medical treatment and frequently endangers the life and limb of the patient when consent for medical and surgical treatment is unavailable and that in order to alleviate this problem it is necessary for this Act to become effective immediately. Therefore, an emergency is hereby declared to exist and this Act being necessary for the immediate preservation of the public peace, health and safety shall be in full force and effect from and after its passage and approval.”

Acts 2019, No. 690, § 2: Apr. 4, 2019. Emergency clause provided: “It is found and determined by the General Assembly of the State of Arkansas that homeless children and youths are going without medical care and treatment that they need; that the State of Arkansas has an interest in the health of homeless children and youths; that this act would authorize local educational agency liaisons to consent to medical treatment for homeless children and youths; and that this act is immediately necessary to ensure that homeless children and youths receive the medical care and treatment that they need. Therefore, an emergency is declared to exist, and this act being immediately necessary for the preservation of the public peace, health, and safety shall become effective on: (1) The date of its approval by the Governor; (2) If the bill is neither approved nor vetoed by the Governor, the expiration of the period of time during which the Governor may veto the bill; or (3) If the bill is vetoed by the Governor and the veto is overridden, the date the last house overrides the veto”.

Acts 2019, No. 910, § 6346(b): July 1, 2019. Emergency clause provided: “It is found and determined by the General Assembly of the State of Arkansas that this act revises the duties of certain state entities; that this act establishes new departments of the state; that these revisions impact the expenses and operations of state government; and that the sections of this act other than the two uncodified sections of this act preceding the emergency clause titled ‘Funding and classification of cabinet-level department secretaries’ and ‘Transformation and Efficiencies Act transition team’ should become effective at the beginning of the fiscal year to allow for implementation of the new provisions at the beginning of the fiscal year. Therefore, an emergency is declared to exist, and Sections 1 through 6343 of this act being necessary for the preservation of the public peace, health, and safety shall become effective on July 1, 2019”.

20-9-601. Definition.

1. As used in this subchapter, “of unsound mind” means the inability to perceive all relevant facts related to one's condition and proposed treatment so as to make an intelligent decision based thereon, whether or not the inability is:
   1. Only temporary, has existed for an extended period of time, or occurs or has occurred only intermittently; or
   2. Due to natural state, age, shock or anxiety, illness, injury, drugs or sedation, intoxication, or other cause of whatever nature.
2. An individual shall not be considered to be of unsound mind based solely upon his or her refusal of medical care or treatment.

History. Acts 1981, No. 511, § 2; A.S.A. 1947, § 82-363.1.

20-9-602. Consent generally — Definition.

It is recognized and established that, in addition to other authorized persons, any one (1) of the following persons may consent, either orally or otherwise, to any surgical or medical treatment or procedure not prohibited by law that is suggested, recommended, prescribed, or directed by a licensed physician:

1. Any adult, for himself or herself;
2. 1. Any parent, whether an adult or a minor, for his or her minor child or for his or her adult child of unsound mind, whether the child is of the parent's blood, an adopted child, a stepchild, a foster child not in custody of the Department of Human Services, or a preadoptive child not in custody of the department.
   2. However, the father of an illegitimate child cannot consent for the child solely on the basis of parenthood;
3. Any married person, whether an adult or a minor, for himself or herself;
4. Any female, regardless of age or marital status, for herself when given in connection with pregnancy or childbirth, except the unnatural interruption of a pregnancy;
5. Any person standing in loco parentis, whether formally serving or not, and any guardian, conservator, or custodian, for his or her ward or other charge under disability;
6. Any emancipated minor, for himself or herself;
7. Any unemancipated minor of sufficient intelligence to understand and appreciate the consequences of the proposed surgical or medical treatment or procedures, for himself or herself;
8. Any adult, for his or her minor sibling or his or her adult sibling of unsound mind;
9. During the absence of a parent so authorized and empowered, any maternal grandparent and, if the father is so authorized and empowered, any paternal grandparent, for his or her minor grandchild or for his or her adult grandchild of unsound mind;
10. Any married person, for a spouse of unsound mind;
11. Any adult child, for his or her mother or father of unsound mind;
12. Any minor incarcerated in the Division of Correction or the Division of Community Correction, for himself or herself;
13. 1. Any foster parent or preadoptive parent, for a child in custody of the department in:
       1. 1. Emergency situations.
          2. As used in this subdivision (13)(A)(i), “emergency situation” means a situation in which, in competent medical judgment, the proposed surgical or medical treatment or procedures are immediately or imminently necessary and any delay occasioned by an attempt to obtain consent would reasonably be expected to jeopardize the life, health, or safety of the person affected or would reasonably be expected to result in disfigurement or impaired faculties;
       2. Routine medical treatment;
       3. Ongoing medical treatment;
       4. Nonsurgical procedures by a primary care provider; and
       5. Nonsurgical procedures by a specialty care provider.
    2. The department shall be given timely notice of all admissions and discharges consented to by a foster parent or preadoptive parent for a child in custody of the department.
    3. The consent of a representative of the department is required for:
       1. Nonemergency surgical procedures;
       2. Nonemergency invasive procedures;
       3. “End-of-life” nonemergency procedures, such as do-not-resuscitate orders, withdrawal of life support, and organ donation; and
       4. Nonemergency medical procedures relating to a criminal investigation or judicial proceeding that involves gathering forensic evidence; and
14. A local educational agency liaison for homeless children and youths under the federal McKinney-Vento Homeless Assistance Act, 42 U.S.C. § 11432 et seq., as existing on January 1, 2019, when the minor patient:
    1. Meets the definition of a homeless child or youth under the federal McKinney-Vento Homeless Assistance Act, 42 U.S.C. § 11432 et seq., as existing on January 1, 2019;
    2. Is not in the care or custody of a parent or guardian; and
    3. Is not in the care or custody of the department.

History. Acts 1973, No. 328, § 1; 1981, No. 511, § 1; A.S.A. 1947, § 82-363; Acts 1995, No. 632, § 1; 1997, No. 875, § 1; 2009, No. 700, § 1; 2019, No. 690, § 1; 2019, No. 910, § 996.

Amendments. The 2009 amendment subdivided (2) and inserted “not in custody of the Department of Human Services, or a preadoptive child not in custody of the Department of Human Services” in (2)(A); added (13); and made related changes.

The 2019 amendment by No. 690 added (14); and made stylistic changes.

The 2019 amendment by No. 910 substituted “Division of Correction” for “Department of Correction” and “Division of Community Correction” for “Department of Community Correction” in (12).

20-9-603. Implied consent — Definition.

In addition to any other instances in which consent is excused or implied at law, consent to surgical or medical treatment or procedures suggested, recommended, prescribed, or directed by a licensed physician will be implied in the following circumstances:

1. 1. When an emergency exists and there is no one immediately available who is authorized, empowered to, or capable of consent.
   2. “Emergency” means a situation in which, in competent medical judgment, the proposed surgical or medical treatment or procedures are immediately or imminently necessary and any delay occasioned by an attempt to obtain a consent would reasonably be expected to jeopardize the life, health, or safety of the person affected or would reasonably be expected to result in disfigurement or impaired faculties; and
2. When any emergency exists, there has been a protest or refusal of consent by a person authorized and empowered to do so, and there is no other person immediately available who is authorized, empowered, or capable of consenting but there has been a subsequent material and morbid change in the condition of the affected person.

History. Acts 1973, No. 328, § 2; 1977, No. 805, § 1; A.S.A. 1947, § 82-364.

20-9-604. Consent given by court in emergency.

1. 1. Except as provided in subsection (e) of this section, consent may be given by a court when:
      1. An emergency exists;
      2. There has been a protest or refusal of consent by a person authorized and empowered to do so; and
      3. There is no other person immediately available who is authorized, empowered, or capable of consent.
   2. The consent shall be given upon the presentation of a petition accompanied by the written advice or certificate of one (1) or more licensed physicians that in their professional opinion there is an immediate or imminent necessity for medical or surgical treatment or procedures.
   3. Any circuit judge may summarily grant injunctive and declaratory relief ordering and directing that the necessary surgical or medical treatment or procedures be rendered, provided that the affected person is:
      1. A pregnant female in the last trimester of pregnancy;
      2. A person of insufficient age or mental capacity to understand and appreciate the nature of the proposed surgical or medical treatment and the probable consequences of refusal of the treatment; or
      3. A parent of a minor child, provided that the court in its discretion finds that the life or health of the parent is essential to the child's financial support or physical or emotional well-being.
2. Any circuit judge granting the declaratory and injunctive relief directing the provision of surgical or medical treatment or procedures pursuant to this section shall be immune from liability based on any claim that the surgical or medical treatment or procedures for the affected person should not have been administered.
3. The reasonable expense incurred for emergency surgical or medical treatment or procedures administered pursuant to this section shall be borne by:
   1. The estate of the person affected;
   2. Any person liable at law for the necessities of the person affected; or
   3. If the estate or person is unable to pay, the county of residence of the person receiving the surgical or medical care.
4. Upon request of an attending physician, any other licensed physician, or a representative of a hospital to which a patient has been admitted or presented for treatment, it shall be the duty of the prosecuting attorney, or his or her designee, of the county in which the surgical or medical care is proposed to be rendered to give his or her assistance in the presentation of the petition, with medical advice or certificate, and in obtaining an order from the court of proper jurisdiction.
5. 1. Consent may be given by a court when an emergency exists and there is no one immediately available who is authorized, empowered to, or capable of consent for a person of unsound mind or there has been a subsequent material and morbid change in the condition of the affected person who is in the custody of the Division of Correction or the Division of Community Correction.
   2. The consent shall be given upon the presentation of a petition accompanied by the written advice or certificate of one (1) or more licensed physicians that in their professional opinion there is an immediate or imminent necessity for medical or surgical treatment or procedures.
   3. Any circuit judge may summarily grant injunctive and declaratory relief ordering and directing that the necessary surgical or medical treatment or procedures be rendered.

History. Acts 1977, No. 805, § 2; A.S.A. 1947, § 82-364.1; Acts 1997, No. 875, § 2; 2019, No. 910, § 997.

Amendments. The 2019 amendment substituted “Division of Correction” for “Department of Correction” and “Division of Community Correction” for “Department of Community Correction” in (e)(1).

Subchapter 7 — Medicare

Preambles. Acts 1973, No. 416, contained a preamble which read:

“Whereas, the Medicare program, which is financed by taxpayer funds provides for payment to physicians for medical services rendered to Medicare patients; and

“Whereas, under the present system, payments to physicians are based on five localities resulting in reasonable charge prevailing limits in urban areas which are frequently higher than the prevailing limits in rural areas for similar services; and

“Whereas, the rural areas of the State are in dire need of additional physicians to meet the health needs of those areas, yet, we are discriminating against and discouraging physicians going to rural areas by providing lower prevailing limits of payment for services rendered by such physicians to Medicare patients; and

“Whereas, it is believed that since the Medicare program is financed by tax funds contributed to equally by the citizens in all areas of the State, reasonable charge prevailing limits for physician's services under the program should be uniform in all areas of the State;

“Now, therefore … .”

Effective Dates. Acts 1969, No. 87, § 2: Feb. 21, 1969. Emergency clause provided: “It is hereby found and determined by the General Assembly that it is essential that physicians and others serving on hospital utilization review committees for the purpose of determining questions relative to the hospitalization of Medicare patients be given immunity from liability for decisions of judgment in the performance of their duties so long as such decisions are made in good faith, and that this Act is immediately necessary to provide such immunity. Therefore, an emergency is hereby declared to exist and this Act being immediately necessary for the preservation of the public peace, health and safety shall be in effect from the date of its passage and approval.”

20-9-701. Uniform Medicare charges.

The agency administering the Medicare program in Arkansas shall establish reasonable charges on a single statewide basis according to field of practice. The reasonable charges shall be based on uniform prevailing limits for all physicians throughout the state for the same or similar services.

History. Acts 1973, No. 416, § 1; A.S.A. 1947, § 66-5101.

20-9-702. Immunity of hospital utilization review committees.

1. Physicians and others appointed to hospital utilization review committees for the purpose of determining questions relating to the hospitalization of Medicare patients under the Health Insurance for the Aged and Disabled Act, 42 U.S.C. § 1395 et seq., shall be immune from liability with respect to decisions made as to such questions as long as the physicians or others act in good faith and without malice.
2. However, nothing in this section shall be construed to relieve any patient's personal physician of any liability which he or she may have in connection with the treatment of the patient.

History. Acts 1969, No. 87, § 1; A.S.A. 1947, § 82-359.

Subchapter 8 — Transplants

Cross References. Revised Arkansas Anatomical Gift Act, 20-17-1201 et seq.

Effective Dates. Acts 1971, No. 462, § 3: Mar. 30, 1971. Emergency clause provided: “It having been found by the General Assembly that the transplantation and transfusion of human tissues is a necessary part of the protection of human health and life and that hospitals and physicians are reluctant to perform these services under existing conditions and that the immediate passage of this act is necessary for the protection of the health, safety and welfare of the people of the State of Arkansas, an emergency is hereby declared to exist and this act shall take effect immediately upon its passage and approval.”

20-9-801. Declaration of policy.

1. The availability of scientific knowledge, skills, and materials for the transplantation, injection, transfusion, or transfer of human tissue, organs, blood, and components thereof is important to the health and welfare of the people of this state.
2. The imposition of legal liability without fault upon the persons and organizations engaged in such scientific procedures inhibits the exercise of sound medical judgment and restricts the availability of important scientific knowledge, skills, and materials.
3. It is therefore the public policy of this state to promote the health and welfare of the people by limiting the legal liability arising out of such scientific procedures to instances of negligence or willful misconduct.

History. Acts 1971, No. 462, § 1; A.S.A. 1947, § 82-1607.

20-9-802. Limitation of liability.

No physician, surgeon, hospital, blood bank, tissue bank, or other person or entity who donates, obtains, prepares, transplants, injects, transfuses, or otherwise transfers or who assists or participates in obtaining, preparing, transplanting, injecting, transfusing, or transferring any tissue, organ, blood, or component thereof from one (1) or more human beings, living or dead, to another human being, shall be liable as the result of the activity, except that each such person or entity shall remain liable for negligence or willful misconduct only.

History. Acts 1971, No. 462, § 2; A.S.A. 1947, § 82-1608.

Subchapter 9 — Utilization Review

Effective Dates. Acts 1989, No. 537, § 19: Jan. 1, 1990.

Acts 1993, No. 1045, § 5: Apr. 12, 1993. Emergency clause provided: “It is hereby found and determined by the General Assembly that a carry forward provision should apply to application fees in the utilization review program for the effective administration of the program. Therefore, an emergency is hereby declared to exist and this act being necessary for the immediate preservation of the public peace, health and safety shall be in full force and effect from and after its passage and approval.”

20-9-901. Purpose.

The purpose of this subchapter is to:

1. Promote the delivery of quality health care in a cost-effective manner;
2. Foster greater coordination between payors and providers conducting utilization review activities;
3. Protect patients, business, and providers by ensuring that private review agents are qualified to perform utilization activities and to make informed decisions on the appropriateness of medical care; and
4. Ensure that private review agents maintain the confidentiality of medical records.

History. Acts 1989, No. 537, § 2.

20-9-902. Definitions.

As used in this subchapter:

1. [Repealed.]
2. “Certificate” means a certificate of registration granted by the State Board of Health to a private review agent;
3. 1. “Private review agent” means a nonhospital-affiliated person or entity performing utilization review on behalf of:
      1. An employer of employees in the State of Arkansas; or
      2. A third party that provides or administers hospital and medical benefits to citizens of this state, including:
         1. A health maintenance organization issued a certificate of authority under and by virtue of the laws of the State of Arkansas; and
         2. A health insurer, nonprofit health service plan, health insurance service organization, or preferred provider organization or other entity offering health insurance policies, contracts, or benefits in this state.
   2. “Private review agent” does not include automobile, homeowner, or casualty and commercial liability insurers or their employees, agents, or contractors;
4. “Utilization review” means a system for review which reviews the appropriate and efficient allocation of hospital resources and medical services given or proposed to be given to a patient or group of patients; and
5. “Utilization review plan” means a description of the utilization review procedures of a private review agent.

History. Acts 1989, No. 537, § 1; 2001, No. 1729, § 1; 2019, No. 389, § 13.

Amendments. The 2019 amendment repealed (1).

20-9-903. Certificate required.

A private review agent who approves or denies payment or who recommends approval or denial of payment for hospital or medical services or whose review results in approval or denial of payment for hospital or medical services on a case-by-case basis may not conduct utilization review in this state unless the State Board of Health has granted the private review agent a certificate.

History. Acts 1989, No. 537, § 3.

20-9-904. When certificate not required.

1. The State Board of Health may waive the requirements of this subchapter for the activities of a private review agent in connection with a contract with the United States Government for utilization review of patients eligible for hospital and medical services under the Social Security Act.
2. No certificate is required for those private review agents conducting general in-house utilization review for hospitals, home health agencies, preferred provider organizations, other managed care entities, clinics, private offices, or any other health facilities or entities, so long as the review does not result in the approval or denial of payment for hospital or medical services for a particular case. The general in-house utilization review is exempt from this subchapter.
3. No certificate is required for utilization review by any Arkansas-licensed pharmacist or pharmacy, or organizations of either, while engaged in the practice of pharmacy, including, but not limited to, dispensing of drugs, participation in drug utilization reviews, and monitoring patient drug therapy.

History. Acts 1989, No. 537, §§ 4, 9.

U.S. Code. The Social Security Act, referred to in this section, is codified primarily in Title 42 of the U.S. Code.

20-9-905. Penalty.

1. A person who violates any provision of this subchapter or any rule adopted under this subchapter shall be guilty of a violation and upon conviction shall be subject to a penalty not exceeding one thousand dollars ($1,000).
2. Each day that a violation is continued after the first conviction is a separate offense.

History. Acts 1989, No. 537, § 12; Acts 2005, No. 1994, § 108; 2019, No. 315, § 1849.

Amendments. The 2019 amendment substituted “rule” for “regulation” in (a).

20-9-906. Duties of State Board of Health.

1. 1. In accordance with the Arkansas Administrative Procedure Act, § 25-15-201 et seq., the State Board of Health shall adopt rules to implement this subchapter.
   2. Rules governing utilization review plans under this subchapter shall impose no greater requirements than those required for utilization review activities for state-certified health maintenance organizations under the laws of this state, as amended from time to time.
   3. Any information required by the board with respect to customers, patients, or utilization review procedures of a private review agent shall be held in confidence and not disclosed to the public.
2. The board shall issue a certificate to an applicant that has met all the requirements of this subchapter and all applicable rules of the board.
3. The board may establish reporting requirements to:
   1. Evaluate the effectiveness of private review agents; and
   2. Determine if the utilization review programs are in compliance with this subchapter and applicable rules.
4. A certificate issued under this subchapter is not transferrable.

History. Acts 1989, No. 537, §§ 3, 10; 2019, No. 315, §§ 1850-1852.

Amendments. The 2019 amendment substituted “rules” for “regulations” throughout the section.

20-9-907. Health insurance plans — Insurers.

1. 1. Every health insurance plan proposing to issue or deliver a health insurance policy or contract or administer a health benefit program which provides for the coverage of hospital and medical benefits and the utilization review of those benefits shall:
      1. Have a certificate in accordance with this subchapter; or
      2. Contract with a private review agent who has a certificate in accordance with this subchapter.
   2. Notwithstanding any other provisions of this subchapter, for claims in which the medical necessity of the provision of a covered benefit is disputed, a health service plan that does not meet the requirements of this subsection shall pay any person or hospital entitled to reimbursement under the policy or contract.
2. 1. Every insurer proposing to issue or deliver a health insurance policy or contract or administer a health benefit program which provides for the coverage of hospital and medical benefits and the utilization review of such benefits shall:
      1. Have a certificate in accordance with this subchapter; or
      2. Contract with a private review agent that has a certificate in accordance with this subchapter.
   2. Notwithstanding any provision of this subchapter, for claims in which the medical necessity of the provision of a covered benefit is disputed, an insurer that does not meet the requirements of this subsection shall pay any person or hospital entitled to reimbursement under the policy or contract.
3. 1. Any health insurer proposing to issue or deliver in this state a group or blanket health insurance policy or administer a health benefit program which provides for the coverage of hospital and medical benefits and the utilization review of such benefits shall:
      1. Have a certificate in accordance with this subchapter; or
      2. Contract with a private review agent that has a certificate in accordance with this subchapter.
   2. Notwithstanding any provision of this subchapter, for claims in which the medical necessity of the provision of a covered benefit is disputed, a health insurer that does not meet the requirements of this subsection shall pay any person or hospital entitled to reimbursement under the policy or contract.

History. Acts 1989, No. 537, §§ 14-16.

20-9-908. Application for certification — Fee.

1. An applicant for a certificate shall:
   1. Submit an application to the State Board of Health; and
   2. Pay to the board the application fee established by the board by rule.
2. The application shall:
   1. Be on a form and accompanied by any supporting documentation that the board requires; and
   2. Be signed and verified by the applicant.
3. The application fee required under this section shall be sufficient to pay for the administrative cost of the certification program and any other cost associated with carrying out this subchapter.
4. 1. All application fees shall be special revenues and deposited to the credit of the Public Health Fund.
   2. Any unexpended balance of such fees at the end of each state fiscal year shall be carried forward to the next fiscal year to be used for the same intent and purposes as set forth in this subchapter.

History. Acts 1989, No. 537, § 5; 1993, No. 1045, § 1; 2019, No. 315, § 1853.

Amendments. The 2019 amendment substituted “by rule” for “through regulation” in (a)(2).

20-9-909. Information required with application.

In conjunction with the application, the private review agent shall submit information that the State Board of Health requires, including:

1. A utilization review plan that includes:
   1. A description of review standards and procedures to be used in evaluating proposed or delivered hospital and medical care; and
   2. The provisions by which patients, physicians, or hospitals may seek reconsideration or appeal of adverse decisions by the private review agent;
2. The type and qualifications of the personnel either employed or under contract to perform the utilization review;
3. The procedures and policies to ensure that a representative of the private review agent is reasonably accessible to patients and providers five (5) days a week during normal business hours in this state;
4. The policies and procedures to ensure that all applicable state and federal laws to protect the confidentiality of individual medical records are followed;
5. A copy of the materials designed to inform applicable patients and providers of the requirements of the utilization review plan; and
6. A list of the third party payors for which the private review agent is performing utilization review in this state.

History. Acts 1989, No. 537, § 6.

20-9-910. Expiration of certificate — Renewal.

1. A certificate expires on the second anniversary of its effective date unless the certificate is renewed for a two-year term as provided in this section.
2. Before the certificate expires, a certificate may be renewed for an additional two-year term if the applicant:
   1. Otherwise is entitled to the certificate;
   2. Pays the State Board of Health the renewal fee set by the board by rule; and
   3. Submits to the board:
      1. A renewal application on the form that the board requires; and
      2. Satisfactory evidence of compliance with any requirement of this subchapter for certificate renewal.

History. Acts 1989, No. 537, § 7; 2019, No. 315, § 1854.

Amendments. The 2019 amendment substituted “by rule” for “through regulation” in (b)(2).

20-9-911. Revocation or denial of certificate.

1. The State Board of Health may revoke or deny a certificate if the holder does not comply with performance assurances under this section, violates any provision of this subchapter, or violates any rule adopted pursuant to this subchapter.
2. The board shall deny a certificate to any applicant if upon review of the application the board finds that the applicant proposing to conduct a utilization review does not:
   1. Have available the services of a sufficient number of qualified medical professionals supported and supervised by appropriate physicians to carry out its utilization review activities;
   2. Meet any applicable rules the board adopted under this subchapter relating to the qualifications of private review agents or the performance of utilization review; and
   3. Provide assurances satisfactory to the board that:
      1. The procedure and policies of the private review agent will protect the confidentiality of medical records; and
      2. The review agent will be reasonably accessible to patients and providers for five (5) working days a week during normal business hours in this state.

History. Acts 1989, No. 537, § 8; 2019, No. 315, §§ 1855, 1856.

Amendments. The 2019 amendment substituted “rule” for “regulation” in (a); and substituted “rules” for “regulations” in (b)(2).

20-9-912. Appeals.

1. 1. Before denying or revoking a certificate under this subchapter, the State Board of Health shall provide the applicant or certificate holder with reasonable time to supply additional information demonstrating compliance with the requirements of this subchapter and the opportunity to request a hearing.
   2. If an applicant or certificate holder requests a hearing, the board shall send a hearing notice and conduct a hearing in accordance with the Arkansas Administrative Procedure Act, § 25-15-201 et seq.
2. Any person aggrieved by a final decision of the board in a contested case under this subchapter may take a direct judicial appeal as provided for in the Arkansas Administrative Procedure Act, § 25-15-201 et seq.

History. Acts 1989, No. 537, §§ 8, 13.

20-9-913. Confidentiality.

A private review agent may not disclose or publish individual medical records or any other confidential medical information obtained in the performance of utilization review activities without the appropriate procedures for protecting the patient's confidentiality. However, nothing in this subchapter shall prohibit private review agents from providing patient information to a third party whom the private review agent is affiliated with, under contract with, or acting on behalf of.

History. Acts 1989, No. 537, § 11.

20-9-914. Liability unaffected.

Nothing in this subchapter shall be deemed to reduce or expand the liability of any person or entity for any actions or activities with respect to utilization review.

History. Acts 1989, No. 537, § 17.

Subchapter 10 — Acute Stroke Care Act of 2005

Effective Dates. Acts 2019, No. 910, § 6346(b): July 1, 2019. Emergency clause provided: “It is found and determined by the General Assembly of the State of Arkansas that this act revises the duties of certain state entities; that this act establishes new departments of the state; that these revisions impact the expenses and operations of state government; and that the sections of this act other than the two uncodified sections of this act preceding the emergency clause titled ‘Funding and classification of cabinet-level department secretaries’ and ‘Transformation and Efficiencies Act transition team’ should become effective at the beginning of the fiscal year to allow for implementation of the new provisions at the beginning of the fiscal year. Therefore, an emergency is declared to exist, and Sections 1 through 6343 of this act being necessary for the preservation of the public peace, health, and safety shall become effective on July 1, 2019”.

20-9-1001. Title.

This subchapter shall be known and may be cited as the “Acute Stroke Care Act of 2005”.

History. Acts 2005, No. 663, § 1.

20-9-1002. Findings.

The General Assembly finds that:

1. The citizens of the State of Arkansas are entitled to the maximum protection which is practicable from the effects of strokes;
2. Each year about seven hundred thousand (700,000) Americans experience a new or recurrent stroke;
3. On average, a stroke strikes someone every forty-five (45) seconds, and someone dies of a stroke every three and one-tenth (3.1) minutes;
4. Stroke is the leading cause of serious, long-term disability in the United States, with about four million seven hundred thousand (4,700,000) stroke survivors alive today;
5. Stroke is the third leading cause of death in the United States, causing fifty-seven and seven-tenths (57.7) deaths per one hundred thousand (100,000) population; and
6. In Arkansas, the death rate from stroke is seventy-five and nine-tenths (75.9) per one hundred thousand (100,000), the highest in the nation.

History. Acts 2005, No. 663, § 1.

20-9-1003. Acute Stroke Care Task Force — Creation.

1. There is created the Acute Stroke Care Task Force to consist of twelve (12) members.
2. The Secretary of the Department of Health shall appoint:
   1. One (1) member to represent the Department of Health;
   2. One (1) member to represent the American Heart Association and the American Stroke Association;
   3. One (1) member to represent the Arkansas Minority Health Commission;
   4. One (1) member to represent the Arkansas Hospital Association, Inc.;
   5. One (1) member to represent the Arkansas Foundation for Medical Care, Inc.;
   6. One (1) member to represent the Fay W. Boozman College of Public Health of the University of Arkansas for Medical Sciences;
   7. One (1) member to represent the Division of Medical Services;
   8. One (1) member to represent emergency medical services;
   9. One (1) member to represent the Arkansas Medical Society, Inc.;
   10. One (1) member to represent the medical insurance industry;
   11. One (1) member to represent the community at large; and
   12. One (1) member to represent the Arkansas Medical, Dental, and Pharmaceutical Association, Inc.
3. 1. Except for the initial members, task force members shall serve three-year terms.
   2. The initial members shall be assigned by lot so as to stagger terms to equalize as nearly as possible the number of members to be appointed each year.
4. If a vacancy occurs, the secretary shall appoint a person who represents the same constituency as the member being replaced.
5. The task force shall elect one (1) of its members to act as chair for a term of one (1) year.
6. A majority of the members shall constitute a quorum for the transaction of business.
7. The task force shall meet as necessary to further the intent and purpose of this subchapter.
8. The Department of Health shall provide office space and staff for the task force.
9. Members of the task force shall serve without pay but may receive expense reimbursement in accordance with § 25-16-902 if funds are available.

History. Acts 2005, No. 663, § 1; 2019, No. 910, §§ 4973, 4974.

Amendments. The 2019 amendment substituted “Secretary of the Department of Health” for “Director of the Department of Health” in the introductory language of (b); and substituted “secretary” for “director” in (d).

20-9-1004. Powers and duties.

The Acute Stroke Care Task Force shall:

1. Make recommendations to the State Board of Health consistent with the intent and purpose of this subchapter;
2. Pursue both public and private funding to further the intent of this subchapter; and
3. Develop standards and policy recommendations considering, but not limited to, the following:
   1. Methods for raising public awareness of the prevalence and treatment considerations for strokes;
   2. The professional development of emergency medical services professionals to identify victims of potential stroke;
   3. The professional development of emergency room and hospital personnel to identify and treat victims of potential stroke;
   4. Methods for encouraging the use of thrombolytics, clot-busting drugs, or other accepted or emerging treatments, when appropriate;
   5. Methods for ensuring that a comprehensive range of stroke recovery services are available to Arkansans as they recover physical and mental functions affected by a stroke;
   6. Methods for developing stroke treatment centers; and
   7. Methods for developing a stroke registry for Arkansas.

History. Acts 2005, No. 663, § 1.

20-9-1005. State Board of Health — Powers and duties.

The State Board of Health, after consultation with the Acute Stroke Care Task Force and if funds are available, may promulgate rules to further the intent of this subchapter.

History. Acts 2005, No. 663, § 1.

Subchapter 11 — Cervical Cancer Care Act of 2005

Effective Dates. Acts 2019, No. 910, § 6346(b): July 1, 2019. Emergency clause provided: “It is found and determined by the General Assembly of the State of Arkansas that this act revises the duties of certain state entities; that this act establishes new departments of the state; that these revisions impact the expenses and operations of state government; and that the sections of this act other than the two uncodified sections of this act preceding the emergency clause titled ‘Funding and classification of cabinet-level department secretaries’ and ‘Transformation and Efficiencies Act transition team’ should become effective at the beginning of the fiscal year to allow for implementation of the new provisions at the beginning of the fiscal year. Therefore, an emergency is declared to exist, and Sections 1 through 6343 of this act being necessary for the preservation of the public peace, health, and safety shall become effective on July 1, 2019”.

20-9-1101. Title.

This subchapter shall be known as the “Cervical Cancer Care Act of 2005”.

History. Acts 2005, No. 1414, § 1.

20-9-1102. Cervical Cancer Task Force — Creation.

1. There is created the Cervical Cancer Task Force to consist of twelve (12) members.
2. The Secretary of the Department of Health shall appoint:
   1. One (1) member to represent the Department of Health;
   2. One (1) member to represent the American Cancer Society;
   3. One (1) member to represent the Arkansas Minority Health Commission;
   4. One (1) member to represent the Arkansas Hospital Association, Inc.;
   5. One (1) member to represent the Arkansas Foundation for Medical Care, Inc.;
   6. One (1) member to represent the Fay W. Boozman College of Public Health of the University of Arkansas for Medical Sciences;
   7. One (1) member to represent the Division of Medical Services;
   8. One (1) member to represent primary care physicians;
   9. One (1) member to represent the Arkansas Medical Society, Inc.;
   10. One (1) member to represent the medical insurance industry;
   11. One (1) member to represent the community at large; and
   12. One (1) member to represent the Arkansas Medical, Dental, and Pharmaceutical Association, Inc.
3. 1. Except for the initial members, task force members shall serve three-year terms.
   2. The initial members shall be assigned by lot so as to stagger terms to equalize as nearly as possible the number of members to be appointed each year.
4. If a vacancy occurs, the secretary shall appoint a person who represents the same constituency as the member being replaced.
5. The task force shall elect one (1) of its members to act as chair for a term of one (1) year.
6. A majority of the members shall constitute a quorum for the transaction of business.
7. The task force shall meet as necessary to further the intent and purpose of this subchapter.
8. The Department of Health shall provide meeting space and administrative support for the task force.
9. Members of the task force shall serve without pay but may receive expense reimbursement in accordance with § 25-16-902 if funds are available.

History. Acts 2005, No. 1414, § 1; 2009, No. 280, §§ 1, 2; 2019, No. 910, §§ 4975, 4976.

Amendments. The 2009 amendment substituted “Department of Health” for “Division of Health of the Department of Health and Human Services” twice in (b) and in (h); and in (b), inserted “Fay W. Boozman” in (b)(6), deleted “Health and” following “Department of” in (b)(7), and substituted “primary care physicians” for “emergency medical services” in (b)(8).

The 2019 amendment substituted “Secretary of the Department of Health” for “Director of the Department of Health” in the introductory language of (b); and substituted “secretary” for “director” in (d).

20-9-1103. Cervical Cancer Task Force — Powers and duties.

1. The Cervical Cancer Task Force shall:
   1. Make recommendations to the Breast Cancer Control Advisory Board consistent with the intent of this subchapter;
   2. Pursue both public and private funding to further the intent of this subchapter; and
   3. Develop standards and policy recommendations considering, but not limited to, the following:
      1. Methods for raising public awareness of the prevalence, causes, prevention, screening, and treatment considerations for cervical cancer;
      2. Methods for raising the medical community's awareness of the prevalence, causes, prevention, screening, and treatment considerations for cervical cancer; and
      3. Methods for ensuring that services across the spectrum of causes, prevention, screening, evaluation, and treatment are available to women in Arkansas.
2. The Arkansas Central Cancer Registry of the Department of Health shall provide an annual cervical cancer report to the task force.

History. Acts 2005, No. 1414, § 1; 2009, No. 280, § 3.

Amendments. The 2009 amendment, in (a)(3), inserted “causes, prevention, screening” in (A), rewrote (B), deleted (C) and (E), and redesignated and rewrote the remaining subdivision as (C); substituted “Department of Health” for “Division of Chronic Disease and Disability Prevention of the Division of Health of the Department of Health and Human Services” in (b); and made related changes.

20-9-1104. State Board of Health — Powers and duties.

After consultation with the Cervical Cancer Task Force and if funds are available, the State Board of Health may promulgate rules to further the intent of this subchapter.

History. Acts 2005, No. 1414, § 1.

Subchapter 12 — Health Facility Infection Disclosure Act of 2007

Effective Dates. As to the effective date of this subchapter, see § 20-9-1208.

Acts 2019, No. 910, § 6346(b): July 1, 2019. Emergency clause provided: “It is found and determined by the General Assembly of the State of Arkansas that this act revises the duties of certain state entities; that this act establishes new departments of the state; that these revisions impact the expenses and operations of state government; and that the sections of this act other than the two uncodified sections of this act preceding the emergency clause titled ‘Funding and classification of cabinet-level department secretaries’ and ‘Transformation and Efficiencies Act transition team’ should become effective at the beginning of the fiscal year to allow for implementation of the new provisions at the beginning of the fiscal year. Therefore, an emergency is declared to exist, and Sections 1 through 6343 of this act being necessary for the preservation of the public peace, health, and safety shall become effective on July 1, 2019”.

20-9-1201. Title.

This subchapter shall be known and may be cited as the “Health Facility Infection Disclosure Act of 2007”.

History. Acts 2007, No. 845, § 1.

20-9-1202. Definitions.

As used in this subchapter:

1. 1. “Health facility” means any of the following facilities:
      1. A hospital, outpatient surgery center, public health center, or recuperation center, as those facilities are defined in § 20-9-201; and
      2. Any other facility determined to be a source of healthcare-associated infections and designated as such by the Department of Health.
   2. “Health facility” does not include:
      1. A physician's office unless the office is otherwise licensed as an outpatient surgery center; or
      2. An establishment furnishing primarily domiciliary care;
2. “Healthcare-associated infection” means a localized or systemic condition in a person that:
   1. Results from adverse reaction to the presence of an infectious agent or a toxin of an infectious agent; and
   2. Was not present or incubating in the person at the time of admission to the health facility; and
3. “National Healthcare Safety Network” means the secure, internet-based surveillance system managed by the Division of Healthcare Quality Promotion at the Centers for Disease Control and Prevention created by the Centers for Disease Control and Prevention for accumulating, exchanging, and integrating relevant information on infectious adverse events associated with healthcare delivery.

History. Acts 2007, No. 845, § 1; 2011, No. 634, § 1; 2013, No. 1132, § 3.

Amendments. The 2011 amendment rewrote (3).

The 2013 amendment, in (3), deleted “data collection” following “Internet-based”, substituted “Healthcare” for “Health”, and inserted “and Prevention”.

20-9-1203. Health facility reports.

1. A health facility shall collect data on healthcare-associated infection rates for the following:
   1. Central line-associated bloodstream infections in an intensive care unit; and
   2. Other categories as provided under § 20-9-1204(e).
2. 1. 1. A health facility may voluntarily submit quarterly reports to the Department of Health on the health facility's healthcare-associated infection rates.
      2. 1. If a health facility elects to submit quarterly reports, the reports shall be submitted to the department:
            1. In a format prescribed by the department; and
            2. By April 30, July 31, October 31, and January 31 of each year.
         2. Each quarterly report shall cover the immediately preceding calendar quarter.
      3. Data in the quarterly reports shall cover a period ending not earlier than one (1) month before the submission of the report.
   2. If the health facility is a division or subsidiary of another entity that owns or operates other health facilities, the quarterly report shall be for the specific division or subsidiary and not for the other entity.
3. 1. A health facility participating in the Centers for Medicare & Medicaid Services Hospital Inpatient Quality Reporting Program or its successor shall authorize the department to have access to the following information that the health facility submits to the National Healthcare Safety Network:
      1. The name of the health facility; and
      2. Any information submitted to the National Healthcare Safety Network in order to satisfy the requirements of the Centers for Medicare & Medicaid Services Hospital Inpatient Quality Reporting Program.
   2. The information contained in the National Healthcare Safety Network database and obtained by the department under this section may be used by the department for surveillance and prevention purposes only and shall not be used for regulatory purposes.

History. Acts 2007, No. 845, § 1; 2011, No. 634, §§ 2, 3.

Amendments. The 2011 amendment deleted former (a)(1) through (4) and redesignated the remaining subdivisions accordingly; and added (c).

20-9-1204. Advisory Committee on Healthcare Acquired Infections.

1. The Secretary of the Department of Health shall appoint an Advisory Committee on Healthcare Acquired Infections, including without limitation representatives of:
   1. Public and private hospitals, including representatives of hospitals with fewer than fifty (50) beds and representatives of hospitals with more than fifty (50) beds;
   2. Outpatient surgery centers;
   3. Direct-care nursing staff;
   4. Physicians;
   5. Infection-control professionals with expertise in healthcare-associated infections;
   6. Academic researchers; and
   7. At least one (1) representative of a consumer organization.
2. The committee shall assist the Department of Health in the development of all aspects of the department's methodology for collecting, analyzing, and disclosing the data collected under this subchapter, including without limitation:
   1. Collection methods;
   2. Formatting; and
   3. Methods and means for the release and dissemination of the data.
3. 1. In developing the methodology for collecting and analyzing the infection-rate data, the department and the committee shall consider existing methodologies and systems for data collection.
   2. Any data collection and analytical methodologies used shall be:
      1. Capable of being validated; and
      2. Based upon nationally recognized and recommended standards that may include those developed by the Centers for Disease Control and Prevention, the Centers for Medicare & Medicaid Services, the United States Agency for Healthcare Research and Quality, or the National Quality Forum.
   3. The proposed data collection and analysis methodology shall be disclosed for public comment before any public disclosure of healthcare-associated infection rates in an annual report under § 20-9-1205.
   4. 1. The data collection and analysis methodology shall be presented to all health facilities in this state on or before September 1, 2008.
      2. The methodology may be amended based upon input from the health facilities.
   5. 1. The first voluntary quarterly report under § 20-9-1203(b) shall be presented to the department on or before January 31, 2009.
      2. Health facilities may begin voluntarily reporting data on January 31, 2009, or at any time thereafter.
4. The department and the committee shall evaluate on a regular basis the quality and accuracy of health facility data reported under this subchapter and the data collection, analysis, and dissemination methodologies used under this subchapter.
5. After release of the second annual report published under § 20-9-1205 and upon consultation with the committee and with other technical advisors who are recognized experts in the prevention, identification, and control of healthcare-associated infections and the reporting of performance data, the department may add categories of infections to those set forth in § 20-9-1203(a) in compliance with the Arkansas Administrative Procedure Act, § 25-15-201 et seq.

History. Acts 2007, No. 845, § 1; 2011, No. 634, § 4; 2019, No. 910, § 4977.

Amendments. The 2011 amendment added “in compliance with the Arkansas Administrative Procedure Act, § 25-15-201 et seq.” at the end of (e).

The 2019 amendment substituted “Secretary of the Department of Health” for “Director of the Department of Health” in the introductory language of (a).

20-9-1205. Reports regarding healthcare-associated infections.

1. 1. 1. In consultation with the Advisory Committee on Healthcare Acquired Infections, the Department of Health shall submit annually a report summarizing the health facility quarterly reports required under this subchapter to the Chair of the House Committee on Public Health, Welfare, and Labor and the Chair of the Senate Committee on Public Health, Welfare, and Labor.
      2. No health-facility-identifiable data shall be included in the annual report, but aggregate statistical data may be included.
   2. The department shall publish the annual report on the department's website.
   3. The first annual report shall be submitted and published on or before January 1, 2010.
2. The annual report prepared by the department under this subchapter regarding healthcare-associated infections shall be appropriately risk-adjusted.
3. The annual report shall include an executive summary written in plain language that shall include without limitation:
   1. A discussion of findings, conclusions, and trends concerning the overall status of healthcare-associated infections in the state, including a comparison to previous years; and
   2. Policy recommendations of the department and the committee.
4. The annual report shall be made available to any person upon request.
5. No health facility report or department disclosure shall contain information identifying a patient, employee, or healthcare professional in connection with a specific infection incident.
6. No annual report or other department disclosure shall contain information that identifies or could be used to identify a specific health facility.
7. 1. As part of the process of preparing the annual report, effective safeguards to protect against the dissemination of inconsistent, incomplete, invalid, inaccurate, or subjective health facility data shall be developed and implemented.
   2. These safeguards may include the exclusion of certain data or data from health facilities with a low volume of patients or procedures if the use of the data would skew the results reported.
8. The department shall develop, with the assistance of the committee, a process of regular and confidential feedback for health facilities regarding the data collected so that each health facility's data will be available to that health facility for its quality improvement efforts.

History. Acts 2007, No. 845, § 1.

20-9-1206. Legislative intent — Privacy and confidentiality.

1. It is the intent of the General Assembly that a patient's right of confidentiality shall not be violated in any manner under this subchapter.
2. Social Security numbers and any other information that could be used to identify an individual patient shall not be released under this subchapter.
3. Except for the annual report that shall be a public document available to any person upon request, any data and materials collected or compiled by a health facility or obtained by the Department of Health under this subchapter shall be exempt from discovery and disclosure to the same extent that records of and testimony before committees evaluating quality of medical or hospital care are exempt under § 16-46-105(a)(1) and shall not be admissible in any legal proceeding.
4. Data collected and reported under this subchapter shall not be deemed to have established a standard of care for any purposes in a private civil litigation.

History. Acts 2007, No. 845, § 1.

20-9-1207. Rules.

The State Board of Health shall promulgate rules to implement this subchapter.

History. Acts 2007, No. 845, § 1.

20-9-1208. Funding.

This subchapter is contingent upon the appropriation and availability of funding necessary for the Department of Health to implement its provisions, and any requirements that actions be accomplished by a specific date shall be extended until the necessary funding is available.

History. Acts 2007, No. 845, § 1.

Subchapter 13 — Arkansas Peer Review Fairness Act

A.C.R.C. Notes. Acts 2017, No. 975, § 8, provided: “SEVERABILITY CLAUSE. If any provision of this act or the application of this act to any person or circumstance is held invalid, the invalidity shall not affect other provisions or applications of this act which can be given effect without the invalid provision or application, and to this end, the provisions of this act are declared severable.”

Effective Dates. Acts 2017, No. 975, § 9: Apr. 7, 2017, § 7. Emergency clause provided: “It is found and determined by the General Assembly of the State of Arkansas that without legislative action, participants in medical staff peer review proceedings will continue to be confused and uncertain as to what remedies are available to address an unfair peer review proceeding and the scope of judicial review; that the standards established in SECTION 7 of this act will help remedy the confusion and uncertainty, prevent harm to physicians and physician-patient relationships, and promote fair independent medical judgment; and that SECTION 7 of this act is immediately necessary to provide a fair process to the physician under review while still providing immunity to individuals serving on professional review bodies. Therefore, an emergency is declared to exist, and SECTION 7 of this act being immediately necessary for the preservation of the public peace, health, and safety shall become effective on: (1) The date of its approval by the Governor; (2) If the bill is neither approved nor vetoed by the Governor, the expiration of the period of time during which the Governor may veto the bill; or (3) If the bill is vetoed by the Governor and the veto is overridden, the date the last house overrides the veto.”

20-9-1301. Title.

This subchapter shall be known and may be cited as the “Arkansas Peer Review Fairness Act”.

History. Acts 2013, No. 766, § 1.

20-9-1302. Findings and intent.

1. The General Assembly finds that:
   1. The peer review process is well established as an acceptable means of monitoring quality and improving care within an institution;
   2. 1. The peer review process faces unique challenges in the hospital setting compared to other healthcare settings due to the interdependent relationship between the hospital and medical staff, which can impact professional review activities.
      2. Peer review that is not conducted fairly results in harm to both patients and physicians by limiting access to care and patient choice; and
   3. It is necessary to balance carefully the rights of patients who benefit by properly conducted peer review with the rights of those who may be harmed by improper peer review.
2. The General Assembly intends that peer review be conducted fairly for the benefit of the citizens of the State of Arkansas.

History. Acts 2013, No. 766, § 1; 2017, No. 975, § 1.

Amendments. The 2017 amendment substituted “an acceptable” for “the most important and effective” in (a)(1); rewrote (a)(2)(A); deleted “However” preceding “Peer review” at the beginning of (a)(2)(B); and inserted “properly conducted” in (a)(3).

20-9-1303. Definitions.

As used in this subchapter:

1. “Adversely affect”, when used in reference to clinical privileges or medical staff membership, means deny, reduce, restrict, suspend, revoke, or fail to renew;
2. “Conflict of interest” means a personal or financial interest that would lead an objective person to conclude that it would be difficult for the person in those circumstances to make a fair and impartial decision in a professional review activity with regard to a particular physician;
3. “Hospital” means a healthcare facility licensed as a hospital by the Division of Health Facilities Services under § 20-9-213;
4. 1. “Investigation” means a process conducted by a professional review body to:
      1. Obtain and make a detailed examination of the facts related to an identified concern about a specific physician; and
      2. Determine whether a professional review action should be requested or recommended.
   2. “Investigation” does not include the following:
      1. A preliminary review to obtain basic information related to a concern or complaint about a physician in order to determine whether an investigation should commence;
      2. Routine quality assurance, case review, utilization review, and performance improvement activities that take place within a hospital; or
      3. Collegial interventions, ongoing physician practice evaluations and focused physician practice evaluations, and other peer-to-peer performance improvement interventions that are not intended to, and do not, impact a physician's clinical privileges or hospital medical staff membership;
5. “Medical staff” means the physicians who are approved and given privileges to provide health care to patients in the hospital;
6. “Professional review action” means an action or recommendation of a professional review body that is taken or made in the conduct of professional review activity and that:
   1. Is based on an individual physician's competence or professional conduct that adversely affects or could adversely affect the health or welfare of a patient or patients; and
   2. Adversely affects or may adversely affect the medical staff membership or clinical privileges of the physician;
7. 1. “Professional review activity” means an activity with respect to an individual physician:
      1. To determine whether the physician may have clinical privileges at a hospital or membership on the hospital's medical staff;
      2. To determine the scope or conditions of clinical privileges or medical staff membership; or
      3. To change or modify such clinical privileges or medical staff membership.
   2. “Professional review activity” includes an investigation, as defined in this section; and
8. “Professional review body” means a hospital, its governing body, or its medical staff when any of these bodies are conducting a professional review activity.

History. Acts 2013, No. 766, § 1; 2017, No. 975, § 1.

Amendments. The 2017 amendment added the definition for “Conflict of interest”; deleted the definition for “Governing body”; redesignated former (4) as (4)(A) and rewrote it; added (4)(B); deleted “and other licensed practitioners” following “physicians” in (5); substituted “medical staff membership” for “hospital membership” in (6)(B); substituted “on” for “in” in (7)(A)(i); deleted “such” preceding “clinical” in (7)(A)(ii); deleted (8)(B); and made stylistic changes.

20-9-1304. Standards for professional review actions and professional review activities.

1. Professional review activity shall be conducted and professional review actions shall be taken in compliance with the requirements of the Health Care Quality Improvement Act of 1986, 42 U.S.C. § 11101 et seq., and the additional requirements of this subchapter.
2. 1. If at any meeting or hearing held in the course of a professional review activity, an attorney is participating on behalf of a professional review body and the physician under review is present, then the physician under review shall be permitted to have the attorney of the physician present.
   2. Subdivision (b)(1) of this section does not:
      1. Entitle the attorney of the physician to appear at any meeting or hearing where an attorney participating on behalf of the peer review body is not present, except as provided in § 20-9-1310;
      2. Prohibit confidential attorney-client communications by any party; or
      3. Prohibit a professional review body from meeting in private with its attorney.
3. The General Assembly encourages:
   1. Professional review bodies to use separate legal counsel from the legal counsel used by the hospital; and
   2. Medical staff to obtain independent legal counsel to review medical staff bylaws to ensure that the bylaws contain provisions that comply with this subchapter.
4. 1. A physician engaged in professional review activities shall exercise unbiased, independent, and professional judgment when evaluating another physician.
   2. A hospital shall not take action against or otherwise retaliate against a physician for exercising unbiased, independent, and professional judgment when evaluating another physician during the course of a professional review activity.

History. Acts 2013, No. 766, § 1; 2017, No. 975, § 1.

Amendments. The 2017 amendment rewrote the section.

20-9-1305. [Repealed.]

Publisher's Notes. This section, concerning medical staff bylaws, was repealed by Acts 2017, No. 975, § 2. The section was derived from Acts 2013, No. 766, § 1. For current law, see § 20-9-1304(c).

20-9-1306. Suspensions.

1. If failure to take a professional review action may result in an imminent danger to the health of any individual, the hospital may immediately suspend or restrict the medical staff membership or clinical privileges of a physician.
2. If an action is taken under subsection (a) of this section, then the hospital shall follow all the other provisions of this subchapter as soon as practicable following the suspension or restriction.
3. In the case of a suspension or restriction of clinical privileges, for a period of not longer than fourteen (14) days, during which an investigation is being conducted to determine the need for a professional review action:
   1. No hearing is required to be held regarding the suspension;
   2. The parties shall comply with § 20-9-1309 and all other applicable provisions of this subchapter; and
   3. The physician shall be given the opportunity to discuss the case with the individual or individuals conducting the investigation during the fourteen (14) days before any recommendation or decision is made about continuing the suspension or restriction.

History. Acts 2013, No. 766, § 1; 2017, No. 975, § 3.

Amendments. The 2017 amendment substituted “parties shall comply with § 20-9-1309 and all other applicable” for “professional review body shall follow the notice” in (c)(2).

20-9-1307. [Repealed.]

Publisher's Notes. This section, concerning actions for equitable relief permitted, was repealed by Acts 2017, No. 975, § 4. The section was derived from Acts 2013, No. 766, § 1. For current law, see § 20-9-1313.

20-9-1308. Relationship to other laws and regulations.

1. 1. Except as provided in subsection (b) of this section, professional review activities are within the categories of records and proceedings that are exempt from discovery and disclosure under state law, including without limitation § 16-46-105(a)(1) and § 20-9-503.
   2. This subchapter does not affect the admissibility in evidence in any action or proceeding of the medical records of any patient.
2. This subchapter does not:
   1. Abrogate the immunity provisions of the Health Care Quality Improvement Act of 1986, 42 U.S.C. § 11101 et seq., or the confidentiality or immunity provisions of § 16-46-105, § 17-1-102, or § 20-9-501 et seq.; or
   2. Prevent discovery and admissibility of evidence from the professional review activities if the legal action is brought by a physician who has been subjected to the professional review activity or action.

History. Acts 2013, No. 766, § 1; 2017, No. 975, § 5.

Amendments. The 2017 amendment rewrote (a)(1); substituted “This subchapter does not” for “Nothing in this subchapter shall” in (a)(2); and rewrote (b).

20-9-1309. Standards for investigations.

1. A physician shall be informed in writing within five (5) business days of the date that the physician becomes a subject of an investigation.
2. Before a professional review body makes a recommendation as a result of an investigation, the physician under review shall be given an opportunity to have a meeting with the professional review body to discuss the matter without the presence of attorneys.
3. 1. 1. If the professional review body decides to use an external review during the investigation, physicians serving on the professional review body that is conducting the investigation are responsible for selecting any external reviewers and the method of selecting cases for review.
      2. However, the physicians serving on the professional review body may seek input regarding the selection described under subdivision (c)(1)(A) of this section from the physician under review or other individuals.
   2. The physician under review shall be included on any substantive communications by any party with the external reviewers selected under subdivision (c)(1)(A) of this section.
4. At the conclusion of the investigation, the physician under review shall be informed of the determination of the professional review body.

History. Acts 2017, No. 975, § 6.

20-9-1310. Standards for hearings and related matters.

1. 1. A physician who is the subject of a proposed professional review action shall be given notice of the proposed professional review action, the basis for the proposed professional review action, and the right to a hearing.
   2. Subdivision (a)(1) of this section does not entitle a physician to a hearing if the proposed professional review action will not adversely affect the physician's clinical privileges or medical staff membership.
2. 1. A hearing shall be held before a hearing officer, arbitrator, hearing panel, or combination of hearing officer, arbitrator, or hearing panel.
   2. A hearing officer or arbitrator shall:
      1. Be independent of all parties involved;
      2. Have no conflict of interest; and
      3. Not:
         1. Have served as an attorney for the hospital or the physician under review at any time within two (2) years before the hearing date; or
         2. Be affiliated with a law firm that has represented the hospital or the physician under review at any time within two (2) years before the hearing date.
   3. 1. The medical staff bylaws shall govern the appointment of members of a hearing panel subject to the requirements of this subsection.
      2. The members of a hearing panel may be members of the medical staff of the hospital.
      3. The members of the hearing panel shall:
         1. Disclose any potential conflicts of interest before the hearing; and
         2. Agree to exercise unbiased, independent, and professional judgment when evaluating the competence or professional conduct of the physician under review.
   4. 1. A physician under review shall have a reasonable opportunity to raise the issue of a potential conflict of interest or other concern related to a hearing officer, arbitrator, or member of a hearing panel.
      2. The medical staff bylaws shall establish a process for considering and resolving any potential conflicts of interest.
3. 1. Before the hearing, the professional review body and the physician under review shall provide the opposing party with a list of any witnesses expected to testify and copies of any documents expected to be introduced at the hearing.
   2. In advance of the hearing, the hospital administration, professional review body, and the physician under review shall disclose all relevant information to each other.
4. At the hearing, the physician under review shall have the right to:
   1. Be present and present evidence on his or her own behalf;
   2. Be represented by an attorney or another individual of the physician's choice at the hearing;
   3. Call, examine, and cross-examine witnesses; and
   4. Submit a written statement.
5. Upon completion of the hearing, the physician under review has a right to receive:
   1. The written recommendation of the hearing officer, arbitrator, or hearing panel, including a statement of the basis of the recommendation; and
   2. A copy of the record of the hearing upon request and payment of any reasonable charges for the preparation of the record.
6. After the hospital takes final action on the recommendation from the hearing, the physician under review is entitled to receive a written decision, including a statement of the basis for the decision.
7. Any dispute over the relevancy or method of discovery or any other dispute that arises during the hearing process shall be resolved by the hearing officer, arbitrator, or hearing panel.

History. Acts 2017, No. 975, § 6.

20-9-1311. Nonwaivable.

1. Unless part of a mutually agreed upon mediation or settlement, a provision in an agreement, policy, procedure, or contract, including bylaws, that purports to waive any provision of this subchapter is void.
2. However, the time periods for compliance with procedural requirements may be waived by mutual consent of the parties on a case-by-case basis.

History. Acts 2017, No. 975, § 6.

20-9-1312. Applicability.

On and after August 1, 2017, this subchapter shall apply to any investigation or professional review activity at any stage.

History. Acts 2017, No. 975, § 6.

20-9-1313. Remedy.

1. Within sixty (60) days of a final decision that adversely affects a physician, a physician may file a petition to remedy a violation of this subchapter by filing the petition in:
   1. The circuit court of the county in which the professional review activity occurred; or
   2. The circuit court of an adjoining county.
2. 1. After receiving a petition, the court shall review the record of the professional review activities and professional review action.
   2. The record shall consist of:
      1. The transcripts and minutes of any meetings or hearings;
      2. Correspondence;
      3. Internal and external reviews; and
      4. All other relevant information pertaining to the matter before the professional review body.
   3. The hospital shall transmit the record, but the court may require or permit subsequent corrections or additions to the record.
   4. The review conducted by the court shall be confined to the record, except upon a showing of good cause to go beyond the record.
   5. The court may hear, upon request, oral arguments and receive written briefs.
   6. Absent a showing of bad faith, a member of the medical staff who participated in the professional review activity shall not be compelled to testify in court under this subsection.
3. Except as provided in subsection (e) of this section, the court may order any relief within the purview of the circuit court to remedy the violation of this subchapter.
4. 1. If a physician prevails under this section, the physician shall be entitled to reasonable attorney's fees, costs, and expenses as determined by the court.
   2. A defendant who prevails shall be entitled to reasonable attorney's fees, costs, and expenses as determined by the court to the extent permitted under the Health Care Quality Improvement Act of 1986, 42 U.S.C. § 11113, as existing on January 1, 2017.
5. Except as expressly permitted by state law or federal law, a professional review body or its members, agents, or employees are not liable for civil damages as a result of making a decision or recommendation in good faith in connection with a professional review activity or professional review action or furnishing any records, information, or assistance in good faith to a professional review body in connection with a professional review activity.
6. 1. The remedies provided for in this section do not supplant any other remedy available under law to a physician.
   2. If a physician has more than one (1) cause of action, all causes of action may be joined in the same pleading.

History. Acts 2017, No. 975, § 7.

Subchapter 14 — Carter's Law: The Shaken Baby Syndrome Education Program

Effective Dates. Acts 2019, No. 910, § 6346(b): July 1, 2019. Emergency clause provided: “It is found and determined by the General Assembly of the State of Arkansas that this act revises the duties of certain state entities; that this act establishes new departments of the state; that these revisions impact the expenses and operations of state government; and that the sections of this act other than the two uncodified sections of this act preceding the emergency clause titled ‘Funding and classification of cabinet-level department secretaries’ and ‘Transformation and Efficiencies Act transition team’ should become effective at the beginning of the fiscal year to allow for implementation of the new provisions at the beginning of the fiscal year. Therefore, an emergency is declared to exist, and Sections 1 through 6343 of this act being necessary for the preservation of the public peace, health, and safety shall become effective on July 1, 2019”.

20-9-1401. Definitions.

As used in this subchapter:

1. “Child care facility” means a facility licensed under the Child Care Facility Licensing Act, § 20-78-201 et seq.;
2. “Freestanding birthing center” means a facility, institution, or place, which is not an ambulatory surgical center or a hospital or in a hospital, organized to provide family-centered maternity care for women and childbearing families in which births are planned to occur in a homelike atmosphere away from the mothers' residences following a low-risk pregnancy;
3. “Hospital” means an institution that has been licensed, certified, or approved by the Division of Health Facilities Services as a hospital;
4. 1. “Maternity unit” means a unit or place in a hospital in which women are regularly received and provided care during all or part of the maternity cycle.
   2. “Maternity unit” does not include an emergency department or similar place dedicated to providing emergency health care;
5. “Parent” means:
   1. Either parent;
   2. If the parents are separated or divorced or their marriage has been dissolved or annulled, the parent who is the residential parent and legal custodian of the child; and
   3. A prospective adoptive parent with whom a child is placed; and
6. “Shaken baby syndrome” means signs and symptoms resulting from the violent shaking or the shaking and impacting of the head of an infant or child, including without limitation:
   1. Retinal hemorrhage;
   2. Subdural hematoma; and
   3. Cerebral edema.

History. Acts 2013, No. 1208, § 2.

20-9-1402. Shaken baby syndrome education program established.

1. The Secretary of the Department of Health shall establish the shaken baby syndrome education program by:
   1. Not later than one (1) year after August 16, 2013, developing educational materials that present readily comprehensible information for new parents on shaken baby syndrome; and
   2. Making available on the Department of Health website in an easily accessible format the educational materials developed under subdivision (a)(1) of this section.
2. 1. An individual or entity may create educational materials concerning shaken baby syndrome.
   2. An individual or entity that develops educational materials under subdivision (b)(1) of this section shall submit the materials for approval by the department before distributing the educational materials.
   3. If the department approves educational materials submitted under subdivision (b)(2) of this section, the individual or entity may distribute the educational materials at the individual's or entity's expense.
3. 1. Annually beginning on or before January 1, 2014, the secretary shall assess the effectiveness of the shaken baby syndrome education program.
   2. The department shall submit a biennial report of the assessment under subdivision (c)(1) of this section to the Chair of the House Committee on Public Health, Welfare, and Labor and the Chair of the Senate Committee on Public Health, Welfare, and Labor.

History. Acts 2013, No. 1208, § 2; 2019, No. 910, §§ 4978, 4979.

Amendments. The 2019 amendment substituted “Secretary of the Department of Health” for “Director of the Department of Health” in the introductory language of (a); and substituted “secretary” for “director” in (c)(1).

20-9-1403. Distribution of shaken baby syndrome educational materials.

1. A copy of the shaken baby syndrome educational materials developed under § 20-9-1402 or comparable material shall be distributed:
   1. By a child birth educator, a pediatric physician's office, or an obstetrician's office to an expectant parent who uses the services of the child birth educator or staff;
   2. By a hospital or freestanding birthing center in which a child is born to the child's parent who is present at the hospital or freestanding birthing center before the child is discharged from the facility;
   3. By a child care facility to the parent with whom the child resides; and
   4. By a child care facility to each employee of the child care facility.
2. An entity or a person required to distribute educational materials under subsection (a) of this section is not subject to civil or criminal liability for an injury, a death, or a loss to a person or property resulting from the dissemination of, or failure to disseminate, the educational materials.

History. Acts 2013, No. 1208, § 2.

20-9-1404. Data on shaken baby syndrome.

1. At the conclusion of a child maltreatment investigation under the Child Maltreatment Act, § 12-18-101 et seq., if a child has been shaken or has an abusive or nonaccidental head trauma, the investigative agency shall identify the type of physical abuse in the child welfare information system.
2. The Department of Human Services shall include data on the number of children who suffer abusive head trauma, nonaccidental head trauma, and shaken baby syndrome in the annual Arkansas Child Welfare Report Card required under § 9-32-204.

History. Acts 2013, No. 1208, § 2.

20-9-1405. Rules.

The State Board of Health shall adopt rules to implement this subchapter.

History. Acts 2013, No. 1208, § 2.

Subchapter 1 — General Provisions

Effective Dates. Acts 1969, No. 58, § 17: Jan. 1, 1970.

Acts 1979, No. 28, § 15: Feb. 1, 1979. Emergency clause provided: “It is hereby found and determined by the General Assembly that there is a need for an Office of Long Term Care and that the immediate passage of this Act is necessary in order that the reorganization contemplated by this Act may be accomplished on or before July 1, 1979. Therefore, an emergency is hereby declared to exist and this Act being necessary for the immediate preservation of the public peace, health and safety shall be in full force and effect from and after its passage and approval.”

Acts 1987, No. 602, § 5: Apr. 4, 1987. Emergency clause provided: “It is hereby found and determined by the General Assembly that in order to meet the State's responsibility in assuring that head injured individuals are afforded a high quality of services and to further enhance the effective and coordinated regulation of long term care facilities through the functions of the Office of Long Term Care the immediate passage of this Act is necessary. Therefore, an emergency is hereby declared to exist and this Act being immediately necessary for the preservation of the public peace, health and safety shall be in full force and effect from and after its passage and approval.”

Acts 1988 (4th Ex. Sess.), No. 17, § 6: July 15, 1988. Emergency clause provided: “It is hereby found and determined by the General Assembly that the state lacks procedures to adequately protect the infirmed and frail elderly who reside in long-term care facilities within this state; That this act should go into effect immediately upon passage to shorten the amount of time required for necessary rules and regulations to be promulgated for implementation of this act and to provide at the earliest possible date some assurance to the residents of long-term care facilities that a high quality of life and the protection of their welfare and health is necessary and important to the entire citizenry of the State of Arkansas. Therefore, an emergency is hereby declared to exist and this act being necessary for the preservation of the public peace, health and safety shall be in full force and effect from and after its passage and approval.”

Acts 1991, No. 1085, § 35: July 1, 1991. Emergency clause provided: “It is hereby found and determined by the Seventy-Eighth General Assembly, that the Constitution of the State of Arkansas prohibits the appropriation of funds for more than a two (2) year period; that the effectiveness of this Act on July 1, 1991 is essential to the operation of the agency for which the appropriations in this Act are provided, and that in the event of an extension of the Regular Session, the delay in the effective date of this Act beyond July 1, 1991 could work irreparable harm upon the proper administration and provision of essential governmental programs. Therefore, an emergency is hereby declared to exist and this Act being necessary for the immediate preservation of the public peace, health and safety shall be in full force and effect from and after July 1, 1991.”

Acts 2005, No. 2191, § 11: Apr. 13, 2005. Emergency clause provided: “It is found and determined by the General Assembly of the State of Arkansas that various long-term care facilities are operating in this state without having obtained a license; that there is no state oversight or protection for the vulnerable residents in these facilities; and that there is no way of ensuring that the facilities properly treat and protect these residents under state long-term care laws. Therefore, an emergency is declared to exist and this act being immediately necessary for the preservation of the public peace, health, and safety shall become effective on: (1) The date of its approval by the Governor; (2) If the bill is neither approved nor vetoed by the Governor, the expiration of the period of time during which the Governor may veto the bill; or (3) If the bill is vetoed by the Governor and the veto is overridden, the date the last house overrides the veto.”

Acts 2019, No. 910, § 6346(b): July 1, 2019. Emergency clause provided: “It is found and determined by the General Assembly of the State of Arkansas that this act revises the duties of certain state entities; that this act establishes new departments of the state; that these revisions impact the expenses and operations of state government; and that the sections of this act other than the two uncodified sections of this act preceding the emergency clause titled ‘Funding and classification of cabinet-level department secretaries’ and ‘Transformation and Efficiencies Act transition team’ should become effective at the beginning of the fiscal year to allow for implementation of the new provisions at the beginning of the fiscal year. Therefore, an emergency is declared to exist, and Sections 1 through 6343 of this act being necessary for the preservation of the public peace, health, and safety shall become effective on July 1, 2019”.

20-10-101. Definitions.

As used in this chapter:

1. “Administrative remedy” means temporary management, denial of payment for all new admissions, transfer of residents, termination or suspension of license, termination of provider agreement, directed plan of correction, directed in-service training, and remedies established by Arkansas law, including remedies provided in § 20-10-1408;
2. “Administrator-in-training program” means a program for gaining supervised practical experience in long-term care administration;
3. “Assisted living facility” means the same as in § 20-10-1703;
4. “Clock hour” means a period of contact experience comprising the full sixty (60) minutes;
5. “Department” means the Department of Human Services;
6. [Repealed.]
7. “Division” means the appropriate division as determined by the Secretary of the Department of Human Services;
8. “Head injury” means a noncongenital injury to the brain or a neurological impairment caused by illness, accident, or nondegenerative etiology;
9. “Head injury retraining and rehabilitation” means an individualized program of instruction designed to assist an individual suffering disability as a result of head injury to reduce the adverse effects of the disability and improve functioning in activities of daily living and work-related activities, but which does not include inpatient diagnostic care, and which may be offered in a residential or day program;
10. 1. “Long-term care facility” means a nursing home, residential care facility, assisted living facility, post-acute head injury retraining and residential care facility, or any other facility which provides long-term medical or personal care.
    2. “Long-term care facility” does not include an adult day care program that:
       1. Provides care and supervision to meet the needs of twelve (12) or fewer functionally impaired adults at any time in a place other than the adult's home;
       2. Provides services to clients for periods of four (4) hours or less per day for only one (1) day per week;
       3. Designates an individual to act as the program director to have responsibility for the operation of the program;
       4. Posts a notice in eighteen-point type that:
          1. Is located at or near the main entrance to the structure in which the program operates;
          2. Lists the name and contact information of the program director;
          3. Lists the name and the contact telephone number for the Adult Protective Services Unit of the Department of Human Services; and
          4. Lists the name and the contact telephone number for the Office of Long-Term Care;
       5. Operates in a building or structure that is at all times in compliance with safety code requirements as determined by the local fire authority; and
       6. Operates in accordance with the Alzheimer's Association Dementia Care Practice Recommendations or similarly nationally recognized standards for the treatment and care of individuals with Alzheimer's disease or related dementia, as in existence on January 1, 2009;
11. “Long-term care facility administrator” means a person who administers, manages, supervises, or is in general administrative charge of a long-term care facility whether or not the individual has an ownership interest in the long-term care facility and whether or not his or her functions and duties are shared with one (1) or more individuals;
12. “Post-acute head injury residential care” means a residential program offering assistance in activities of daily living for individuals who are disabled because of head injury and are therefore unable to live independently;
13. “Post-acute head injury residential care facility” means a residential care facility which is not a nursing home and which provides head injury retraining and rehabilitation for individuals who are disabled because of head injury and are not in present need of inpatient diagnostic care in a hospital or related institution;
14. “Reciprocity licensing” means a method by which an individual licensed in good standing in one (1) state may apply for licensure status in another state, provided that the state from which the individual wishes to transfer has standards comparable to the state to which the individual wishes to transfer;
15. “Residential care facility” means a building or structure which is used or maintained to provide for pay on a twenty-four-hour basis a place of residence and board for three (3) or more individuals whose functional capabilities may have been impaired but who do not require hospital or nursing home care on a daily basis but who could require other assistance in activities of daily living; and
16. “Sponsor” means legal guardian.

History. Acts 1969, No. 58, § 1; 1975, No. 119, § 1; 1979, No. 28, § 1; 1985, No. 884, § 3; 1985, No. 968, § 3; A.S.A. 1947, §§ 82-2201, 82-2216; Acts 1987, No. 602, §§ 1, 2; 1988 (4th Ex. Sess.), No. 17, § 2; 1993, No. 1090, § 1; 1993, No. 1238, § 4; 2005, No. 898, § 1; 2005, No. 2191, § 2; 2007, No. 827, § 150; 2009, No. 357, § 1; 2019, No. 910, §§ 5175, 5176.

Amendments. The 2009 amendment, in (10), inserted (10)(B), redesignated the remaining text accordingly, and made a related change.

The 2019 amendment repealed (6); and substituted “Secretary of the Department of Human Services” for “Director of the Department of Human Services” in (7).

20-10-102. [Repealed.]

Publisher's Notes. This section, concerning disposition of funds, was repealed by Acts 1993, No. 1238, § 9. The section was derived from Acts 1969, No. 58, § 14; 1983, No. 738, § 1; A.S.A. 1947, § 82-2214.

20-10-103. Post-acute head injury treatment facilities.

1. No certificate of need or permit shall be required under any law in connection with facilities offering head injury retraining and rehabilitation.
2. Post-acute head injury residential facilities shall not be eligible to receive any state Medicare or Medicaid moneys.

History. Acts 1987, No. 602, § 3.

20-10-104. Photographing prohibited — Exceptions.

1. Except as provided in subsection (d) or subsection (e) of this section, a resident of a long-term care facility in this state shall not be photographed without obtaining prior written consent from the resident or, in cases of incapacity, from the guardian or legal representative of the resident.
2. 1. When an employee or agent of a long-term care facility photographs a resident under conditions in which consent is required, the evidence of the consent shall be maintained in the file of the resident at the long-term care facility.
   2. The consent described in subdivision (b)(1) of this section shall be continuously effective unless the consent is rescinded in writing by the resident or the guardian or legal representative of the resident.
3. Failure to obtain consent before photographing a resident in a long-term care facility shall be a Class B misdemeanor.
4. This section does not prevent:
   1. A person licensed under the Arkansas Medical Practices Act, § 17-95-201 et seq., § 17-95-301 et seq., and § 17-95-401 et seq., from photographing a patient for purposes of medical treatment;
   2. A person licensed by the Arkansas State Board of Nursing from photographing a patient for purposes of medical treatment;
   3. Facility staff or agents from photographing a resident of a long-term care facility on social occasions; or
   4. The taking of a photograph by security cameras or other devices for the safety or security of residents.
5. 1. The photographing of residents is permitted without written consent from the resident or the guardian or legal representative of the resident when the photographing is in connection with a survey or investigation made by the Department of Human Services, the Office of the Attorney General, or the United States Department of Health and Human Services, or any agent of the listed entities while in the course of:
      1. Licensure inspections;
      2. Medicaid certification;
      3. A complaint investigation; or
      4. An investigation of allegations of abuse or neglect of residents or misappropriation of residents' property.
   2. Under the circumstances listed in subdivision (e)(1) of this section, the photographs shall be used only for evidentiary purposes concerning the alleged violations and shall not be released to the media or to the public but shall be made available to the facility if utilized to impose a remedy or to set forth a statement of deficiency.

History. Acts 1989, No. 33, § 2; 1999, No. 709, § 1; 2017, No. 568, § 1.

Amendments. The 2017 amendment rewrote the section.

20-10-105. Residential care facility — Ineligibility for reimbursement — Exclusions.

1. Any facility that meets the definition of a residential care facility as defined by the Office of Long-Term Care that has not been licensed or certified by the appropriate state agency or has not received a permit of approval from the Health Services Permit Agency shall not be eligible for any reimbursement from state revenues for any services that it offers.
2. This section does not apply to residential care facilities that have been exempted by law from the permit-of-approval process.

History. Acts 1991, No. 1085, § 25; 1991, No. 922, § 16; 2001, No. 1800, § 15; 2005, No. 2191, § 3.

20-10-106. Nursing home alternatives — Income eligibility for participation in state funding.

1. The maximum income eligibility for participation in state funding for nursing home alternatives shall be established at two hundred percent (200%) of the Supplemental Security Income level as provided by law.
2. This section shall in no way affect the Medicaid program or the Medicaid eligibility or benefits of any person.

History. Acts 1991, No. 1157, §§ 1, 2.

20-10-107. Long-term care facility — Notice of certain incidents — Definition.

1. As used in this section, “long-term care facility” means “long-term care facility” as defined by § 20-10-213.
2. 1. Within twenty-four (24) hours after the incident requiring notification occurs, a long-term care facility shall notify, if known, the resident's guardian or other responsible party when:
      1. The resident suffers an injury;
      2. The resident is taken outside the facility for medical care;
      3. The resident is moved to a different room; or
      4. There is any significant change in the physical or mental condition of the resident.
   2. A long-term care facility that does not comply with this subsection commits a Class C violation under § 20-10-205 and is subject to a civil penalty under § 20-10-206.
3. 1. It is the responsibility of the long-term care facility to obtain an address and telephone number at which the resident's guardian or other responsible party is available for notification.
   2. It is the responsibility of the resident's guardian or other responsible party to notify the long-term care facility of any change in address or telephone number.

History. Acts 1993, No. 1123, §§ 1-4; 2005, No. 1994, § 109; 2011, No. 190, § 1; 2013, No. 1132, § 4.

Amendments. The 2011 amendment substituted “if known, the resident's guardian or other responsible party” for “by telephone and in writing the legal representative or guardian of a resident of the facility” in (b)(1); and rewrote (b)(2) and (c).

The 2013 amendment inserted “commits a Class C violation under § 20-10-205 and” in (b)(2).

20-10-108. Quality of dietary management in long-term care facilities.

1. Persons responsible for the direction of food services in long-term care facilities having more than fifty (50) beds, at a minimum, shall be:
   1. Certified as a certified dietary manager or food service supervisor; or
   2. Enrolled in a food service supervisor's course approved by the Office of Long-Term Care.
2. 1. Certified dietary managers or food service supervisors shall be required to complete fifteen (15) hours of continuing education per year.
   2. The continuing education courses shall be offered by the Association of Nutrition and Foodservice Professionals or a comparable body and shall be approved by the office in order for the courses to be counted toward completion of the fifteen (15) hours.
3. Long-term care facilities having fifty (50) or fewer beds shall allot adequate hours per week for the certified dietary manager or food service supervisor to perform supervisory duties.

History. Acts 1999, No. 1362, §§ 1-3; 2007, No. 827, § 151.

20-10-109. Findings — Intent.

1. The General Assembly finds that:
   1. Residents in Arkansas' long-term care facilities are particularly vulnerable to the theft or illegal diversion of personal funds designated as residents' share of cost under the Arkansas Medicaid program;
   2. The theft or illegal diversion of residents' share of cost under the program has an adverse impact on the resources available to ensure high-quality care for all facility residents; and
   3. This section and § 20-10-110 are necessary to:
      1. Protect long-term care residents' rights;
      2. Provide appropriate resources for residents' care; and
      3. Ensure that residents' funds designated to pay for long-term care are used for that purpose.
2. The General Assembly intends that this section and § 20-10-110 affect individuals who intentionally steal or divert residents' share of cost and not change the obligations or responsibilities of residents of long-term care facilities or deter legitimate disputes over the amount of a resident's share of cost.

History. Acts 2005, No. 1273, § 1.

20-10-110. Protection of residents' personal funds — Definitions.

1. As used in this section:
   1. “Agent” means a person who manages, uses, controls, or otherwise has legal access to a resident's income or resources that legally may be used to pay a resident's share of cost or other charges not paid by the Arkansas Medicaid program;
   2. “Long-term care facility” means a nursing home, residential care facility, post-acute head injury retraining and residential care facility, or any other facility that provides long-term medical or personal care;
   3. “Medicaid recipient” means any individual in whose behalf any person claimed or received any payment or payments from the program; and
   4. “Resident” means a person:
      1. Who resides on a permanent and full-time basis in a long-term care facility;
      2. Who is a Medicaid recipient; and
      3. Whose facility care is paid, in whole or in part, by Medicaid.
2. 1. No long-term care facility may require a third-party guarantee of payment to the facility as a condition of admission, expedited admission, or continued stay in the facility.
   2. However, a long-term care facility may require an agent who has legal access to a resident's income or resources available to pay for facility care to sign a contract without incurring personal financial liability to provide facility payment from the resident's income or resources.
3. An agent who guarantees payment under subdivision (b)(2) of this section shall be personally liable to the facility for payment of a resident's share of cost or other charges incurred by the resident if and to the extent that the agent uses a resident's income or resources for purposes other than the resident's facility care.
4. Unless otherwise exempted by law or contract, a resident or his or her agent shall pay for the resident's share of cost or other charges not paid for by Medicaid.
5. If a resident who has not been a Medicaid recipient becomes a Medicaid recipient, the long-term care facility shall make a reasonable attempt to contact the Arkansas Medicaid program to determine the resident's share of cost.
6. 1. If a resident or his or her agent disputes the amount of share of cost owed to a long-term care facility, the resident or the agent may apply for a hearing under the rules of the Department of Human Services for a determination of the amount of share of cost owed to the long-term care facility.
   2. The hearing shall be limited to only a determination of the amount of share of cost owed to the long-term care facility and shall not result in a determination that names the person or persons responsible for the payment of that share.
7. Any agent who knowingly violates this section is guilty of a misdemeanor and shall be punished by a fine not to exceed two thousand five hundred dollars ($2,500) or by imprisonment not to exceed one hundred eighty (180) days, or both.

History. Acts 2005, No. 1273, § 1.

20-10-111. Disclosure statement for residential care and assisted living facilities.

1. Each residential care and assisted living facility shall provide each prospective resident or prospective resident's representative with a comprehensive consumer disclosure statement before the prospective resident signs an admission agreement.
2. The disclosure statement shall include, but not be limited to:
   1. Proof of current licensure through the Office of Long-Term Care;
   2. A list of services provided by the facility, including, but not limited to:
      1. Any medication administration, assistance taking medication, or reminders to take medication that the facility may by law, rule, or regulation provide;
      2. Any assistance the facility provides with activities of daily living, such as grooming, toileting, ambulation, and bathing;
      3. The availability of transportation; and
      4. Social activities inside and outside the facility;
   3. Staffing levels or ratios required by law, including, but not limited to, those concerning:
      1. Registered nurses;
      2. Licensed nurses;
      3. Certified nurse's aides or assistants; and
      4. Other staff;
   4. Whether staff members are required to be awake while on duty and, if not, the times when they may be asleep; and
   5. Information regarding the physical plant of the facility, including, but not limited to:
      1. Whether the facility has an emergency generator and, if so, the areas of the facility powered by a generator and the length of time the generator will provide power;
      2. Whether the facility has sprinklers and, if so, the areas of the facility that have sprinklers;
      3. Whether the facility has smoke detectors and, if so, the areas in which smoke detectors are located; and
      4. 1. Whether the facility has an emergency evacuation plan.
         2. If the facility has an emergency evacuation plan, a copy of the plan shall be provided to each prospective resident or the prospective resident's representative before the signing of an admission agreement.
3. The facility shall update its disclosure statement no less than annually.

History. Acts 2005, No. 2002, § 1; 2019, No. 315, § 1857.

Amendments. The 2019 amendment substituted “law, rule, or regulation” for “law or regulation” in (b)(2)(A).

20-10-112. Results of a survey, inspection, or investigation prohibited in advertisements.

1. Except as otherwise provided in this section, the results of a survey, inspection, or investigation of a long-term care facility conducted by any state or federal department or agency, including any statement of deficiencies, all findings and deficiencies cited in a statement of deficiencies, all proposed and implemented plans of correction, and all statements of interviews with individuals in connection with any inspection or investigation, shall not be used in an advertisement, unless the advertisement includes all of the following:
   1. The date the survey, inspection, or investigation was conducted;
   2. A statement that a facility is required to submit a plan of correction in response to a statement of deficiencies, if applicable;
   3. If a finding or deficiency cited in the statement of deficiencies has been corrected, a statement that the finding or deficiency has been corrected and the date that the finding or deficiency was corrected; and
   4. A statement that the advertisement is not authorized or endorsed by the Office of Long-Term Care of the Department of Human Services or any other government agency.
2. This section does not prohibit the results of a survey, inspection, or investigation conducted under this section from being used in an administrative proceeding or a criminal investigation or prosecution.
3. The information required in subsection (a) of this section shall:
   1. Be in the same font and size as the other language on or in the advertisement; and
   2. Appear as prominently as other language used in the advertisement.

History. Acts 2015, No. 1054, § 1.

Subchapter 2 — Office of Long-Term Care

Publisher's Notes. Acts 1961, No. 414, codified in this subchapter as §§ 20-10-214 — 20-10-228, is also codified as § 20-9-201 et seq.

Effective Dates. Acts 1969, No. 58, § 17: Jan. 1, 1970.

Acts 1971, No. 258, § 5: became law without Governor's signature, Mar. 9, 1971. Emergency clause provided: “It is found and declared by the General Assembly of Arkansas that Act 414 of 1961, and amendments thereto, does not clearly provide the State Board of Health with the authority to license, inspect and regulate Recuperation Centers, that such intermediate health care facilities are desirable and necessary, and that there is great need for such authority to be clearly and immediately established. Therefore, an emergency is hereby declared to exist, and this Act being necessary for the preservation of the public peace, health and safety, shall be in full force and effect from the date of its passage and approval.”

Acts 1975, No. 190, § 4: Feb. 18, 1975. Emergency clause provided: “It is hereby found and determined by the General Assembly that there is an urgent need in this State for outpatient surgery centers as defined herein to relieve the severe overcrowding of hospital facilities; that such centers will serve an urgent need of the citizens of this State for additional facilities where minor surgery may be performed without the necessity of entering a hospital and incurring the much higher costs of a hospital, and that this Act should be given effect immediately to permit the establishment and operation of such facilities. Therefore, an emergency is hereby declared to exist and this Act being necessary for the immediate preservation of the public peace, health and safety shall be in full force and effect from and after its passage and approval.”

Acts 1977, No. 536, § 4: Mar. 18, 1977. Emergency clause provided: “It is hereby found and determined by the General Assembly that there is an urgent need in this State for outpatient psychiatric centers as defined herein to relieve the severe overcrowding of hospital facilities; that such centers will serve an urgent need of the citizens of this State for additional facilities where psychiatric services may be provided without the necessity of entering a hospital and incurring the much higher costs of a hospital, and that this Act should be given effect immediately to permit the establishment and operation of such facilities. Therefore, an emergency is hereby declared to exist and this Act being necessary for the immediate preservation of the public peace, health and safety shall be in full force and effect from and after its passage and approval.”

Acts 1979, No. 28, § 15: Feb. 1, 1979. Emergency clause provided: “It is hereby found and determined by the General Assembly that there is a need for an Office of Long Term Care and that the immediate passage of this Act is necessary in order that the reorganization contemplated by this Act may be accomplished on or before July 1, 1979. Therefore, an emergency is hereby declared to exist and this Act being necessary for the immediate preservation of the public peace, health and safety shall be in full force and effect from and after its passage and approval.”

Acts 1981, No. 908, § 3: Mar. 28, 1981. Emergency clause provided: “It is hereby found and determined by the General Assembly that in order to meet the State's responsibility in assuring that residents in long term care facilities are afforded a high quality of patient care and to further enhance the effective and coordinated regulation of long term care facilities through the functions of the Office of Long Term Care the immediate passage of this Act is necessary. Therefore, an emergency is hereby declared to exist and this Act being immediately necessary for the preservation of the public peace, health, and safety shall be in full force and effect from and after its passage and approval.”

Acts 1983, No. 273, § 3: Feb. 25, 1983. Emergency clause provided: “It is hereby found and determined by the General Assembly that the length and variety of billing forms now used by third-party carriers is an important source of administrative expense for hospitals and patients; that hospital cost containment is essential to the health, safety and welfare of the people and should be encouraged; and that a uniform billing form, if implemented without delay, will provide a significant savings in hospital costs in this State. Therefore an emergency is hereby declared to exist and this Act being necessary for the preservation of the public peace, health and safety shall be in full force and effect from and after its passage and approval.”

Acts 1987, No. 894, § 5: emergency clause failed to pass. Emergency clause provided: “It is hereby found and determined by the General Assembly that, in order to meet the State's responsibility in assuring that residents of long term care facilities are afforded a high quality of patient care and to futher enhance the effective and coordinated regulation of long term care facilities through the functions of the Office of Long Term Care, the immediate passage of the this Act is necessary. Therefore, an emergency is hereby declared to exist and this Act, being immediately necessary for the preservation of the public peace, health, and safety, shall be in full force and effect from and after its passage and approval.”

Identical Acts 1987 (4th Ex. Sess.), No. 4, § 6 and No. 14, § 6: July 15, 1988. Emergency clause provided: “It is hereby found and determined by the General Assembly that during recent months, certain inadequacies in the continuum of health care for the older citizens of this State have been brought to the attention of the General Assembly; that this Act is necessary to assure each citizen of this State in need of long-term care that a high quality of care at affordable cost will be provided; that the older citizenry of this State deserve the best possible care; that the immediate passage of this Act is essential to the health, welfare and safety of the citizens of the State of Arkansas and to avoid irreparable harm upon the proper administration of an essential government program. Therefore, an emergency is hereby declared to exist and this act being necessary for the preservation of the public peace, health and safety shall be in full force and effect from and after its passage and approval.”

Acts 1987 (4th Ex. Sess.), No. 16, § 3: July 15, 1988. Emergency clause provided: “It is hereby found and determined by the General Assembly that during recent months, certain inadequacies in the continuum of health care for the older citizens of this State have been brought to the attention of the General Assembly; that this Act is necessary to assure each citizen of this State in need of long-term care that a high quality of care at affordable cost will be provided; that the older citizenry of this State deseve the best possible care; that the immediate passage of this Act is essential to the health, welfare and safety of the citizens of the State of Arkansas and to avoid irreparable harm upon the proper administration of an essential government program. Therefore, an emergency is hereby declared to exist and this act being necessary for the preservation of the public peace, health and safety shall be in full force and effect from and after its passage and approval.”

Acts 1991, No. 636, § 5: Mar. 19, 1991. Emergency clause provided: “It is hereby found and determined by the Seventy-Eighth General Assembly of the State of Arkansas that applicants and licensees for long-term care facilities and administrators licenses must now go to Pulaski County Circuit Court in order to appeal decisions of the Office of Long-Term Care and do it within fifteen (15) days of the decision; that this makes it terribly inconvenient and costly for licensees and administrators who must drive long distances to reach Pulaski County and take off days to attend the court hearings; and that these circumstances create an inefficient and inequitable situation which must be corrected immediately. Therefore, in order to alleviate this inefficient system of appeals, an emergency is hereby declared to exist, and this act being necessary for the immediate preservation of the public peace, health, and safety, shall be in full force and effect from and after its passage and approval.”

Acts 1991, No. 922, § 28: July 1, 1991. Emergency clause provided: “It is hereby found and determined by the Seventy-Eighth General Assembly, that the Constitution of the State of Arkansas prohibits the appropriation of funds for more than a two (2) year period; that the effectiveness of this Act on July 1, 1991 is essential to the operation of the agency for which the appropriations in this Act are provided, and that in the event of an extension of the Regular Session, the delay in the effective date of this Act beyond July 1, 1991 could work irreparable harm upon the proper administration and provision of essential governmental programs. Therefore, an emergency is hereby declared to exist and this Act being necessary for the immediate preservation of the public peace, health and safety shall be in full force and effect from and after July 1, 1991.”

Acts 1991, No. 1129, § 33: July 1, 1991. Emergency clause provided: “It is hereby found and determined by the Seventy-Eighth General Assembly, that the Constitution of the State of Arkansas prohibits the appropriation of funds for more than a two (2) year period; that the effectiveness of this Act on July 1, 1991 is essential to the operation of the agency for which the appropriations in this Act are provided, and that in the event of an extension of the Regular Session, the delay in the effective date of this Act beyond July 1, 1991 could work irreparable harm upon the proper administration and provision of essential governmental programs. Therefore, an emergency is hereby declared to exist and this Act being necessary for the immediate preservation of the public peace, health and safety shall be in full force and effect from and after July 1, 1991.”

Acts 1997, No. 1025, § 6: Apr. 2, 1997. Emergency clause provided: “It is hereby found and determined by the General Assembly that this act excludes certain transitional pediatric rehabilitation facilities from the permit of approval process; and that this act is immediately necessary to allow such facilities to proceed without delay. Therefore, an emergency is declared to exist and this act being immediately necessary for the preservation of the public peace, health and safety shall become effective on the date of its approval by the Governor. If the bill is neither approved nor vetoed by the Governor, it shall become effective on the expiration of the period of time during which the Governor may veto the bill. If the bill is vetoed by the Governor and the veto is overridden, it shall become effective on the date the last house overrides the veto.”

Acts 2001, No. 91, § 2: Feb. 6, 2001. Emergency clause provided: “It is found and determined by the General Assembly that maintaining a safe and stable environment for the elderly and infirm is a duty of this State; that the immediate passage and implementation of this act is necessary to protect the health and welfare of the elderly and infirm who are currently being well cared for in private homes and are at imminent risk of being unjustly uprooted from their current residence; and that the mental trauma, disorientation, and possible physical complications that would result from their relocation would cause them to suffer irreparable harm. Therefore, an emergency is declared to exist and this act being immediately necessary for the preservation of the public peace, health and safety shall become effective on the date of its approval by the Governor. If the bill is neither approved nor vetoed by the Governor, it shall become effective on the expiration of the period of time during which the Governor may veto the bill. If the bill is vetoed by the Governor and the veto is overridden, it shall become effective on the date the last house overrides the veto.”

Acts 2005, No. 2191, § 11: Apr. 13, 2005. Emergency clause provided: “It is found and determined by the General Assembly of the State of Arkansas that various long-term care facilities are operating in this state without having obtained a license; that there is no state oversight or protection for the vulnerable residents in these facilities; and that there is no way of ensuring that the facilities properly treat and protect these residents under state long-term care laws. Therefore, an emergency is declared to exist and this act being immediately necessary for the preservation of the public peace, health, and safety shall become effective on: (1) The date of its approval by the Governor; (2) If the bill is neither approved nor vetoed by the Governor, the expiration of the period of time during which the Governor may veto the bill; or (3) If the bill is vetoed by the Governor and the veto is overridden, the date the last house overrides the veto.”

Identical Acts 2016 (3rd Ex. Sess.), Nos. 2 and 3, § 129: May 23, 2016. Emergency clause provided: “It is found and determined by the General Assembly of the State of Arkansas that this act revises the membership and duties of certain agencies, task forces, committees, and commissions and repeals other governmental entities; that these revisions and repeals of governmental entities impact the expenses and operations of state government; and that the provisions of this act should become effective as soon as possible to allow for implementation of the new provisions in advance of the upcoming fiscal year. Therefore, an emergency is declared to exist, and this act being immediately necessary for the preservation of the public peace, health, and safety shall become effective on: (1) The date of its approval by the Governor; (2) If the bill is neither approved nor vetoed by the Governor, the expiration of the period of time during which the Governor may veto the bill; or (3) If the bill is vetoed by the Governor and the veto is overridden, the date the last house overrides the veto.”

Acts 2019, No. 910, § 6346(b): July 1, 2019. Emergency clause provided: “It is found and determined by the General Assembly of the State of Arkansas that this act revises the duties of certain state entities; that this act establishes new departments of the state; that these revisions impact the expenses and operations of state government; and that the sections of this act other than the two uncodified sections of this act preceding the emergency clause titled ‘Funding and classification of cabinet-level department secretaries’ and ‘Transformation and Efficiencies Act transition team’ should become effective at the beginning of the fiscal year to allow for implementation of the new provisions at the beginning of the fiscal year. Therefore, an emergency is declared to exist, and Sections 1 through 6343 of this act being necessary for the preservation of the public peace, health, and safety shall become effective on July 1, 2019”.

20-10-201. Legislative intent.

The General Assembly declares that this act is necessary to assure the effective and coordinated regulation of long-term care facilities and long-term care facility administrators within an orderly organizational structure of government at such levels of economy as are consistent with the state's policy of promoting high standards of quality in the services and to eliminate overlapping and duplication of effort.

History. Acts 1979, No. 28, § 2; A.S.A. 1947, § 82-2217.

Publisher's Notes. Acts 1979, No. 28, § 3, provided that it is the intent of the General Assembly to provide for an orderly transfer of powers, duties, and functions relative to the regulation of long-term care facilities and long-term care facility administrators vested in the Department of Health to the Office of Long-Term Care with a minimum of disruption of governmental services and functions and with a minimum of expense. The section further provided that, towards that end, Acts 1979, No. 28, § 3, should be liberally construed.

Meaning of “this act”. Acts 1979, No. 28, codified as §§ 20-10-101, 20-10-201 — 20-10-206, 20-10-208 — 20-10-210, 20-10-301 — 20-10-303 [repealed].

20-10-202. Creation.

There is created an Office of Long-Term Care within the appropriate division as determined by the Secretary of the Department of Human Services. The head of the office shall be appointed by the secretary.

History. Acts 1979, No. 28, § 4; A.S.A. 1947, § 82-2219; Acts 2019, No. 910, § 5177.

Amendments. The 2019 amendment substituted “Secretary of the Department of Human Services” for “Director of the Department of Human Services” in the first sentence; and substituted “Secretary of the Department of Human Services” for “director” in the second sentence.

20-10-203. Powers and duties.

1. The Office of Long-Term Care is designated as the unit of state government primarily responsible for the inspection, regulation, and licensure of long-term care facilities and the regulation and licensure of long-term care facility administrators.
2. The office may promulgate such rules not inconsistent with this chapter as it shall deem necessary or desirable to properly and efficiently carry out the purposes and intent of this chapter.

History. Acts 1969, No. 58, § 13; 1979, No. 28, § 4; A.S.A. 1947, §§ 82-2213, 82-2219; Acts 2019, No. 315, § 1858.

Amendments. The 2019 amendment deleted “and regulations” following “rules” in (b).

20-10-204. Notice of violation.

1. If upon inspection or investigation the Office of Long-Term Care determines that a licensed long-term care facility is in violation of any federal or state law, rule, or regulation pertaining to Title XIX Medicaid certification or licensure, the office shall promptly serve by certified mail or other means that gives actual notice, a notice of violation upon the licensee when the violation is a classified violation as described in § 20-10-205.
2. Each notice of violation shall:
   1. Be prepared in writing;
   2. Specify the:
      1. Exact nature of the classified violation;
      2. Statutory provision or specific rule alleged to have been violated;
      3. Facts and grounds constituting the elements of the classified violation; and
      4. Amount of civil penalty or other administrative remedy, if any, imposed by the Secretary of the Department of Human Services; and
   3. 1. Inform the licensee of the right to a hearing under § 20-10-208 when administrative remedies or civil penalties are imposed.
      2. Any hearing conducted under this chapter shall conform to the Arkansas Administrative Procedure Act, § 25-15-201 et seq., and rules of the Department of Human Services promulgated under the Arkansas Administrative Procedure Act, § 25-15-201 et seq.

History. Acts 1979, No. 28, § 4; 1981, No. 908, § 1; A.S.A. 1947, § 82-2219; Acts 1987, No. 894, § 3; 1988 (4th Ex. Sess.), No. 4, § 1; 1988 (4th Ex. Sess.), No. 14, § 1; 2005, No. 898, § 2; 2019, No. 315, § 1859; 2019, No. 910, § 5178.

Amendments. The 2019 amendment by No. 315 substituted “state law, rule, or regulation” for “state law or regulation” in (a).

The 2019 amendment by No. 910 substituted “Secretary of the Department of Human Services” for “Director of the Department of Human Services” in (b)(2)(D).

U.S. Code. Title XIX referred to in this section is codified as 42 U.S.C. § 1396 et seq.

20-10-205. Classification of violations.

1. The Office of Long-Term Care shall promulgate rules specifying classified violations in accordance with this section.
2. The notice of violation issued to a long-term care facility by the Director of the Office of Long-Term Care shall be classified according to the nature of the violation and shall indicate the classification on the face of the notice as follows:
   1. Class A violations create a condition or occurrence relating to the operation and maintenance of a long-term care facility resulting in death or serious physical harm to a resident or creating a substantial probability that death or serious physical harm to a resident will result therefrom;
   2. Class B violations create a condition or occurrence relating to the operation and maintenance of a long-term care facility which directly threatens the health, safety, or welfare of a resident;
   3. Class C violations shall relate to administrative and reporting requirements that do not directly threaten the health, safety, or welfare of a resident; and
   4. 1. Class D violations shall relate to the timely submission of statistical and financial reports to the office.
      2. The failure to timely submit a statistical or financial report shall be considered a separate Class D violation during any month or part of a month of noncompliance.
      3. In addition to any civil penalty which may be imposed, the director is authorized, after the first month of a Class D violation, to withhold any further reimbursement to the long-term care facility until the statistical and financial report is received by the office.

History. Acts 1979, No. 28, § 4; 1981, No. 908, § 1; A.S.A. 1947, § 82-2219; Acts 1988 (4th Ex. Sess.), No. 4, § 2; 1988 (4th Ex. Sess.), No. 14, § 2; 2019, No. 315, § 1860.

Amendments. The 2019 amendment deleted “and regulations” following “rules” in (a).

20-10-206. Civil penalties.

1. 1. In the case of a Class A violation, the following civil penalties shall be assessed by the Director of the Office of Long-Term Care against the long-term care facility. In Class B, Class C, or Class D violations, the director, in his or her discretion, may assess the following civil penalties or may allow a specified period of time for correction of the violation:
      1. 1. Class A violations are subject to a civil penalty not to exceed two thousand five hundred dollars ($2,500) for the first violation.
         2. A second Class A violation occurring within a six-month period shall be subject to a civil penalty of five thousand dollars ($5,000).
         3. The third Class A violation occurring within a six-month period from the first violation shall result in proceedings being commenced for termination of the facility's Medicaid agreement and may result in proceedings being commenced for revocation of licensure of the facility;
      2. 1. Class B violations are subject to a civil penalty not to exceed one thousand dollars ($1,000).
         2. A second Class B violation occurring within a six-month period shall be subject to a civil penalty of two thousand dollars ($2,000).
         3. A third Class B violation occurring within a six-month period from the first violation shall result in proceedings being commenced for termination of the facility's Medicaid agreement and may result in proceedings being commenced for revocation of the licensure of the facility;
      3. Class C violations are subject to a civil penalty to be set by the director in an amount not to exceed five hundred dollars ($500) for each violation; and
      4. Class D violations are subject to a civil penalty to be set by the director in an amount not to exceed two hundred fifty dollars ($250) for each violation.
   2. Each subsequent Class C and Class D violation within a six-month period from the last violation shall subject the facility to a civil penalty double that of the preceding violation until a maximum of one thousand dollars ($1,000) per violation is reached.
   3. In no event may the aggregate fines assessed for violations determined in any one (1) month exceed five thousand dollars ($5,000).
2. In determining whether a civil penalty is to be imposed and in fixing the amount of the penalty to be imposed, or if a specified period of time shall be allowed for correction, the following factors shall be considered:
   1. The gravity of the violation, including the probability that death or serious physical harm to a resident will result or has resulted;
   2. The severity and scope of the actual or potential harm;
   3. The extent to which the applicable statutes, rules, or regulations were violated;
   4. The “good faith” exercised by the licensee. Indications of good faith include, but are not limited to:
      1. Awareness of the applicable statutes, rules, and regulations and reasonable diligence in securing compliance;
      2. Prior accomplishments manifesting the licensee's desire to comply with the requirements;
      3. Efforts to correct; and
      4. Any other mitigating factors in favor of the licensee;
   5. Any relevant previous violations committed by the licensee; and
   6. The financial benefit to the licensee of committing or continuing the violation.
3. Assessment of a civil penalty provided by this section shall not affect the right of the Office of Long-Term Care to take such other action as may be authorized by law, rule, or regulation.

History. Acts 1979, No. 28, § 4; 1981, No. 908, § 1; A.S.A. 1947, § 82-2219; Acts 1987, No. 894, §§ 1, 2; 1988 (4th Ex. Sess.), No. 4, § 3; 1988 (4th Ex. Sess.), No. 14, § 3; 2019, No. 315, §§ 1861-1863.

Amendments. The 2019 amendment inserted “rules” in (b)(3) and (b)(4)(A); and inserted “rule” in (c).

20-10-207. Notification to media of violations.

1. When the Office of Long-Term Care's appropriate division, as determined by the Secretary of the Department of Human Services, finds, upon inspection and investigation, that any nursing home or residential care facility has committed two (2) violations constituting Class A or Class B violations as set out in § 20-10-205 during any twelve-month period, the office shall notify the various news media within the county wherein the nursing home or residential care facility is located and shall advise the media that a complete record of the inspection and investigation will be available for public inspection at the office.
2. However, no information shall be made available which will identify any resident, the family of any resident of the nursing home, the residential care facility, or any person who has filed a complaint against a nursing home or against an administrator or any personnel of a nursing home or residential care facility, except in cases of criminal or civil litigation.
3. When the office finds, upon inspection and investigation, that any long-term care facility has committed a Class A or Class B violation, following final determination of the matter on administrative appeal, the long-term care facility administrator shall cause copies of the notice of violation as prepared by the office to be posted on the front entry to the facility to be visible from the interior. The notice shall be posted within seven (7) days of the final determination of the matter on administrative appeal and shall remain posted for a period of not less than sixty (60) days.
4. The notice of violation shall meet the following requirements:
   1. The notice shall read:
      1. “NOTICE
      2. “This facility has been cited with a CLASS A or B VIOLATION.
      3. “Pursuant to § 20-10-205, ‘Class A violations create a condition or occurrence relating to the operation and maintenance of a long-term care facility resulting in death or serious physical harm to a resident or creating a substantial probability that death or serious physical harm to a resident will result therefrom. Class B violations create a condition or occurrence relating to the operation and maintenance of a long-term care facility which directly threatens the health, safety, or welfare of a resident.’
      4. “Date of violation:
      5. “Nature of violation:
      6. “Further information can be obtained from the Office of Long- Term Care at ( number ).
      7. “This notice shall remain posted for a period not less than sixty (60) days from (date ) to (date ).”; and
   2. The notice shall be printed in accordance with the following specifications:
      1. The notice shall be eight and one-half inches by eleven inches (8 ½" x 11") in size;
      2. The notice shall be printed on a white background;
      3. Subdivision (d)(1)(A) of this section shall be printed in red ink in all capital letters at the top center of the page in 48-point boldface type;
      4. Subdivision (d)(1)(B) of this section shall be printed in black ink in 18-point type, except for the words “CLASS A or CLASS B VIOLATION”, which shall be printed in red ink, in capital letters, in 24-point boldface type;
      5. Subdivision (d)(1)(C) of this section shall be printed in black ink with 10-point type. This paragraph shall be indented and boxed;
      6. Subdivisions (d)(1)(D) and (E) of this section shall be underlined and printed in black ink with 18-point type;
      7. Subdivisions (d)(1)(F) and (G) of this section shall be printed in 18-point boldface type; and
      8. The entries to be made shall be written in indelible red ink.
5. A notice of correction may be posted by the facility administrator upon receipt from the office, provided that the notice does not obscure the notice of violation. Posting of the notice of correction shall not reduce the amount of time required for the posting of the notice of violation set forth in subsection (c) of this section.
6. 1. The ombudsman of the Division of Aging, Adult, and Behavioral Health Services of the Department of Human Services shall be furnished with each final copy of a survey upon completion by the office.
   2. 1. The ombudsman shall prepare a one-page form letter which specifically states whether the facility was found in compliance or out of compliance during the most recent annual survey. In addition, the letter shall include the same information from the previous three (3) annual surveys.
      2. The letter shall be considered separately from the survey process and shall not be admissible as evidence in any proceeding by either party in litigation arising from licensure or certification of long-term care facilities.
      3. Copies of the letter shall be furnished by the office to the facility administrator and the Attorney General.
7. 1. A long-term care facility required to be licensed under this subchapter shall post in a conspicuous place, readily accessible to residents and visitors, the final certification survey following final administrative determination as defined by rule of the statement of deficiencies and plans-of-correction survey report received by the facility.
   2. With the survey report, the facility shall post the summary letter prepared by the ombudsman.
   3. The survey report and letter shall remain posted until the next survey report is received by the facility.
8. Failure to post a notice of violation as required by subsection (c) of this section shall be considered a Class C violation under § 20-10-205 for which civil penalties set forth in § 20-10-206 may be imposed, with each day of noncompliance constituting a separate offense. Otherwise, the failure to comply with the requirements of this section by a long-term care facility or facility administrator shall be considered a Class C violation under § 20-10-205 for which civil penalties set forth in § 20-10-206 may be imposed.

History. Acts 1983, No. 468, § 1; A.S.A. 1947, § 82-2219.1; Acts 1988 (4th Ex. Sess.), No. 16, § 1; 1999, No. 1539, § 3; 2017, No. 913, § 56; 2019, No. 315, § 1864; 2019, No. 910, § 5179.

Amendments. The 2017 amendment substituted “Division of Aging, Adult, and Behavioral Health Services” for “Division of Aging and Adult Services” in (f)(1); and made a stylistic change.

The 2019 amendment by No. 315 substituted “rule” for “regulation” in (g)(1).

The 2019 amendment by No. 910, in (a), substituted “Secretary of the Department of Human Services” for “Director of the Department of Human Services” and “set out” for “defined”.

20-10-208. Hearings.

1. 1. A licensee may contest an assessment of a civil penalty or any administrative remedy imposed by the Office of Long-Term Care by sending a written request for a hearing to the Secretary of the Department of Human Services.
   2. Requests for hearings shall be received by the secretary within sixty (60) days after receipt by the licensee of the notice of violation and the assessment of any civil penalty or any administrative remedy imposed by the office.
2. 1. The secretary shall assign the appeal to a fair and impartial hearing officer who shall not be a full-time employee of the Department of Human Services.
   2. The hearing officer shall preside over the hearing and make findings of fact and conclusions of law in the form of a recommendation to the secretary.
   3. The secretary shall review any recommendation and make the final decision. He or she:
      1. May approve the recommendation; or
      2. May for good cause:
         1. Modify the recommendation in whole or in part; or
         2. 1. Remand the recommendation for further proceedings as directed by him or her.
            2. If the recommendation is remanded, the hearing officer shall conduct further proceedings as directed by the secretary and shall submit an amended recommendation to the secretary.
   4. If the secretary modifies a recommendation, in whole or in part, or if the secretary remands the decision, he or she shall state in writing at the time of the remand or modification all grounds for the remand or modification, including statutory, regulatory, factual, or other grounds.
   5. The modification or approval of a recommendation by the secretary shall be the final agency action as provided by the Arkansas Administrative Procedure Act, § 25-15-201 et seq.
3. 1. 1. The department shall commence the hearing within forty-five (45) days of receipt of the request for hearing, and the hearing officer shall notify the Director of the Office of Long-Term Care of the date, time, and place of the hearing.
      2. The notification shall be in writing and shall be sent at least twenty (20) days before the hearing date.
      3. 1. The licensee may agree in writing to waive the requirement that the department commence the hearing within forty-five (45) days.
         2. If the licensee waives the time limit under subdivision (c)(1) (C)(i) of this section, the hearing officer shall commence the hearing at the time agreed to by the parties.
   2. The hearing officer shall issue a recommended decision within ten (10) working days after the close of the hearing, the receipt of the transcript, or the submission of post-trial briefs requested or approved by the hearing officer, whichever is latest.
   3. Unless the secretary acts on the recommendation of the hearing officer within sixty (60) days of receipt of the recommendation, the recommendation of the hearing officer shall be final.
   4. Assessments shall be paid to the office within thirty (30) working days of receipt of the notice of violation or within thirty (30) working days of receipt of the final agency action in contested cases, unless the matter has been timely appealed to circuit court.
   5. Facilities failing to pay assessed civil penalties shall be subject to a corresponding reduction in the succeeding Medicaid vendor payment in lieu of nonpayment.
4. Except to the extent that it is inconsistent with federal law or regulation, a written request for a hearing shall stay until denied by the secretary any enforcement action imposed by the office pending the hearing and the final decision of the secretary.
5. Any party subject to appear before a hearing officer may appear and be heard at any proceeding prescribed in this section or may be represented by an attorney or other designated representative, or both.
6. 1. Upon written request of a licensee, the department shall provide copies of all documents, papers, reports, and other information gathered through inspection or survey that relate to the matter being appealed.
   2. The disclosure shall be made no later than ten (10) working days before a scheduled hearing date or by the date specified by the hearing officer.

History. Acts 1979, No. 28, § 4; 1981, No. 908, § 1; A.S.A. 1947, § 82-2219; Acts 2005, No. 898, § 3; 2011, No. 1139, § 3; 2019, No. 910, §§ 5180-5182.

Amendments. The 2011 amendment deleted (g).

The 2019 amendment substituted “Secretary of the Department of Human Services” for “Director of the Department of Human Services” throughout the section.

20-10-209. Disposition of funds.

1. 1. There is established on the books of the Treasurer of State, Auditor of State, and the Chief Fiscal Officer of the State a trust fund to be known as the “Long-Term Care Trust Fund”.
   2. The fund shall consist of all moneys and interest received from the imposition of civil penalties levied by the state on long-term care facilities found to be out of compliance with the requirements of federal or state law, rules, or regulations, there to be administered by the Secretary of the Department of Human Services solely for the protection of the health or property of residents of long-term care facilities, including, but not limited to, the payment for the costs of relocation of residents to other facilities, maintenance and operation of a facility pending correction of deficiencies or closure, and reimbursement of residents for personal funds lost.
2. Funds from the Long-Term Care Trust Fund may also be administered by the secretary for programs or uses that, in the determination of the Director of the Office of Long-Term Care, enhance the quality of life for long-term care facility residents through the adoption of principles and building designs established by the Eden Alternative, Inc. or Green House Project programs or other means.

History. Acts 1979, No. 28, § 4; 1981, No. 908, § 1; A.S.A. 1947, § 82-2219; Acts 1988 (4th Ex. Sess.), No. 4, § 4; 1988 (4th Ex. Sess.), No. 14, § 4; 2007, No. 193, § 1; 2019, No. 315, § 1865; 2019, No. 910, § 5183.

Amendments. The 2019 amendment by No. 315 inserted “rules” following “law” in (a)(2).

The 2019 amendment by No. 910 substituted “Secretary of the Department of Human Services” for “Director of the Department of Human Services” in (a)(2) and (b); and substituted “Eden Alternative, Inc.” for “Eden Alternative” in (b).

20-10-210. Information received by Office of Long-Term Care confidential.

1. Except in cases of civil or criminal litigation or as permitted in subsection (b) of this section, information received by the Office of Long-Term Care, through inspection or otherwise, shall not be disclosed publicly, in administrative appeals or otherwise, in such a manner as to identify long-term care facility residents, their families, or persons filing complaints against a long-term care facility.
2. Information received or generated by the office, including surveyors' notes, documents, photographs, or other materials gathered, generated, or used by the surveyors in their survey or investigation of a founded complaint, shall be made available to the long-term care facility that is the subject of the survey or investigation upon the completion of the investigation or survey. However, no information that reveals the identity or tends to reveal the identity of any complainant may be disclosed.

History. Acts 1979, No. 28, § 6; A.S.A. 1947, § 82-2221; Acts 1999, No. 1539, § 1; 2001, No. 1774, § 1.

20-10-211. Facilities — Regulation of staffing.

1. The agency responsible for licensure and certification of long-term care facilities shall promulgate appropriate rules prescribing minimum staffing requirements for all long-term care facilities in the state. The agency shall conform to the requirements of the Arkansas Administrative Procedure Act, § 25-15-201 et seq., and other appropriate state laws in promulgating and placing rules into effect.
2. Failure to comply with the rules promulgated by the appropriate agency pursuant to subsection (a) of this section shall be cause for revocation or suspension of the license or certification of any long-term care facility.
3. 1. This section shall apply only to licensed nursing homes.
   2. This section shall not be applicable to any facility of the Division of Developmental Disabilities Services or to any other facility operated by the State of Arkansas or any agency of the state.

History. Acts 1979, No. 169, §§ 1-3; A.S.A. 1947, §§ 82-2223 — 82-2225; Acts 2019, No. 315, § 1866.

Amendments. The 2019 amendment deleted “and regulations” following “rules” throughout the section.

20-10-212. Appeal from denial, suspension, or revocation of license.

1. Any applicant or licensee who is aggrieved by any decision of the Office of Long-Term Care with respect to the denial, suspension, or revocation of any long-term care facility license or long-term care facility administrator license or other final decision of the office with respect to standards of construction, operation, or maintenance of long-term care facilities or long-term care facility personnel or employees may appeal within thirty (30) days the decision of the office to the Pulaski County Circuit Court or to the circuit court of any county in which the applicant or licensee resides or does business.
2. Pending determination of the matter on appeal, the status quo of the applicant or licensee shall be preserved.

History. Acts 1969, No. 58, § 12; A.S.A. 1947, § 82-2212; Acts 1991, No. 636, § 1.

20-10-213. Definitions for §§ 20-10-213 — 20-10-228.

As used in this section and §§ 20-10-214 — 20-10-228:

1. “Department” means the Department of Human Services;
2. “Director” means the Director of the Office of Long-Term Care;
3. “Federal act” means the Hospital Survey and Construction Act, Pub. L. No. 79-725, as amended;
4. 1. 1. “Institution” means a place for the diagnosis, treatment, or care of two (2) or more persons not related to the proprietor’s suffering from illness, injury, or deformity or where obstetrical care or care of the aged, blind, or disabled is rendered over a period exceeding twenty-four (24) hours.
      2. “Institution” also includes an outpatient surgery center and an alcohol and drug abuse treatment center.
   2. No establishment operated by the United States Government or an agency thereof is within this definition;
5. 1. “Long-term care facility” means any building, structure, agency, institution, or other place for the reception, accommodation, board, care, or treatment of more than three (3) unrelated individuals who because of age, illness, blindness, disease, or physical or mental infirmity are unable to sufficiently or properly care for themselves and where a charge is made for that reception, accommodation, board, care, or treatment.
   2. “Long-term care facility” does not include:
      1. The offices of private physicians and surgeons;
      2. Hospitals;
      3. Recuperation centers;
      4. Supervised or supported living apartments, group homes, family homes, or developmental day treatment clinics for individuals with developmental disabilities operated by providers licensed by the Division of Developmental Disabilities Services of the Department of Human Services;
      5. Institutions operated by the United States Government;
      6. Separate living arrangements that do not involve monitoring the activities of the residents while on the premises of the institution or facility to ensure the residents' health, safety, or well-being and that do not involve the institution or facility's being aware of the residents' general whereabouts; or
      7. Hospices;
6. “Medical facility” means a diagnostic or diagnostic and treatment center, a rehabilitation facility, or a nursing home as these terms are defined in the federal act, and any other medical facility for which federal aid may be authorized under federal law;
7. “Office” means the Office of Long-Term Care; and
8. “Surgeon General” means the United States Surgeon General.

History. Acts 1961, No. 414, § 2; 1971, No. 258, § 1; 1975, No. 190, §§ 1, 2; 1977, No. 536, §§ 1, 2; 1985, No. 980, §§ 1, 2; A.S.A. 1947, § 82-328; Acts 1993, No. 909, § 1; 1993, No. 1090, § 2; 1993, No. 1102, § 1; 1997, No. 1028, § 2; 2001, No. 91, § 1; 2001, No. 465, § 1; 2005, No. 2191, § 4; 2017, No. 540, § 38.

A.C.R.C. Notes. Acts 1997, No. 1028, § 1, provided: “Legislative Findings and Intent. It is the intent of this act to provide for the protection, safety and quality of care of elderly and disabled Arkansans by allowing only long-term care facilities that have been licensed, inspected and regulated by the state to operate.”

Amendments. The 2017 amendment repealed (1).

U.S. Code. The Hospital Survey and Construction Act referred to in this section has, for the most part, been eliminated from the United States Code. For remaining provisions, see 48 U.S.C. § 1666 and 42 U.S.C. § 291.

20-10-214. Penalties for §§ 20-10-213 — 20-10-228.

1. Any person, partnership, association, or corporation establishing, conducting, managing, or operating any institution or facility or any combination of separate entities working in concert within the meaning of §§ 20-10-213 — 20-10-228 without first obtaining a license therefor as provided or violating any provision of §§ 20-10-213 — 20-10-228 or rule lawfully promulgated under §§ 20-10-213 — 20-10-228 shall be guilty of a violation.
2. Upon conviction, the person, partnership, association, or corporation shall be liable for a fine of not less than one hundred dollars ($100) nor more than five hundred dollars ($500) for the first offense nor more than one thousand dollars ($1,000) for each subsequent offense.
3. Each day that the institution shall operate after a first conviction shall be considered a subsequent offense.

History. Acts 1961, No. 414, § 27; A.S.A. 1947, § 82-353; Acts 1993, No. 1238, § 5; 2005, No. 1994, § 110; 2019, No. 315, § 1867.

Amendments. The 2019 amendment substituted “rule” for “regulation” in (a).

20-10-215. Injunction for §§ 20-10-213 — 20-10-228.

The Department of Human Services may sue in the name of the state any person, partnership, association, or corporation in order to enjoin the establishing, conducting, managing, or operating of any institution or facility, or any combination of separate entities working in concert within the meaning of §§ 20-10-213 — 20-10-228, without the person's first having secured a license therefor.

History. Acts 1961, No. 414, § 26; A.S.A. 1947, § 82-352; Acts 1993, No. 1238, § 6.

20-10-216. Powers and duties of Department of Human Services.

1. In carrying out §§ 20-10-213 — 20-10-228, the Department of Human Services is empowered and directed to:
   1. Require such reports, make such inspections and investigations, and prescribe and enforce such reasonable rules as it finds necessary to effectuate §§ 20-10-213 — 20-10-228;
   2. Provide methods of administration and appoint a director and other personnel of the Department of Human Services;
   3. Procure and pay for the temporary services of experts or consultants on a fee-for-service basis;
   4. Enter into agreements for the utilization of the facilities and services of other departments, agencies, and institutions, public and private;
   5. Accept on behalf of the state and deposit with the Treasurer of State any grant, gift, or contribution of funds made to assist in meeting the cost of carrying out §§ 20-10-213 — 20-10-228 and expend such funds accordingly;
   6. Make an annual report to the Governor on activities and expenditures made pursuant to §§ 20-10-213 — 20-10-228;
   7. Procure the services of an attorney to assist the Department of Human Services in any legal work involved in carrying out the duties of the Department of Human Services and pay for the services on a fee-for-service or retainer basis; and
   8. Accept a certificate made by an individual's physician that the individual is in need of nursing home care or that he or she can provide for himself or herself.
2. The Department of Human Services shall adopt, promulgate, and enforce such rules and standards as may be necessary for the accomplishment of §§ 20-10-213 — 20-10-228. The rules and standards shall be modified, amended, or rescinded by the Department of Human Services as may be in the public interest.

History. Acts 1961, No. 414, §§ 4, 28; 1983, No. 273, § 1; A.S.A. 1947, §§ 82-330, 82-354; Acts 2005, No. 2191, § 5; 2019, No. 315, §§ 1868, 1869.

Amendments. The 2019 amendment deleted “and regulations” following “rules” in (a)(1); and deleted “regulations” following “rules” twice in (b).

20-10-217. Construction program — Survey and planning activities.

1. The Department of Human Services is empowered and directed to make an inventory of existing medical facilities including public, nonprofit, and proprietary medical facilities, survey the need for construction of medical facilities, and, on the basis of the inventory and survey, develop a program for the construction of such public and other nonprofit medical facilities as will, in conjunction with existing facilities, afford the necessary physical facilities for furnishing adequate medical facility services to the people of the state in accordance with the regulations prescribed by the Hospital Survey and Construction Act, Pub. L. No. 79-725.
2. The construction program shall provide, in accordance with regulations prescribed by the federal act, for adequate medical facilities for the people of the state, and insofar as possible shall provide for their distribution throughout the state in such manner as to make all types of medical facility services reasonably accessible to all persons in the state.

History. Acts 1961, No. 414, §§ 9, 10; A.S.A. 1947, §§ 82-335, 82-336.

20-10-218. Construction program — Federal funds for surveying and planning.

1. The Department of Human Services may make application to the United States Surgeon General for, and receive, federal funds to assist in carrying out the survey and planning activities provided for in § 20-10-217.
2. The funds shall be deposited with the Treasurer of State as a trust fund designated “Hospital and Medical Facility Survey and Planning Fund”, which shall be kept separate and apart from all public funds of the state and shall be available to the department for expenditure in carrying out the survey and planning activities provided.
3. Any funds received and not expended for such purposes shall be repaid to the United States Treasury.
4. Warrants for all payments from the fund shall bear the signature of the Director of the Department of Human Services or his or her agent.

History. Acts 1961, No. 414, § 11; A.S.A. 1947, § 82-337.

20-10-219. Construction program — State plan.

1. 1. The Department of Human Services shall prepare and submit to the United States Surgeon General a state plan which shall include the medical facilities construction program developed as provided in this subchapter. The plan shall provide for the establishment, administration, and operation of medical facilities construction activities in accordance with the requirements of the federal act and regulations under the federal act.
   2. The state plan shall also set forth the relative need for the several projects included in the construction program determined in accordance with regulations prescribed by the federal act and provide for the construction, insofar as financial resources available for construction and for maintenance and operation permit, in the order of relative need.
2. Before the submission of the plan to the United States Surgeon General, the department shall give adequate publicity to a general description of all the provisions proposed to be included therein and hold a public hearing at which all persons or organizations with a legitimate interest in the plan may be given an opportunity to express their views.
3. After approval of the plan by the United States Surgeon General, the department shall cause to be published a general description of the provisions thereof in at least one (1) newspaper having general circulation in each county in the state and shall make the plan, or a copy thereof, available upon request to all interested persons or organizations.
4. The department shall review the construction program, submit to the United States Surgeon General any modifications of the program which it may find necessary, and may submit to the United States Surgeon General modifications of the state plan not inconsistent with the requirements of the federal act.

History. Acts 1961, No. 414, §§ 12, 14; A.S.A. 1947, §§ 82-338, 82-340.

20-10-220. Construction program — Application for funds.

1. Applications for medical facilities construction projects for which federal funds are requested shall be submitted to the Department of Human Services and may be submitted by the state or any political subdivision thereof or by any public or other nonprofit agency authorized to construct and operate a medical facility.
2. However, no application for a diagnostic or treatment center shall be approved unless the applicant is:
   1. The state, a political subdivision, or a public agency; or
   2. A person, corporation, or association which owns and operates a nonprofit hospital.
3. Each application for a construction project shall conform to federal and state requirements.
4. If after affording reasonable opportunity for development and presentation of applications in the order of relative need the department finds that a project application complies with the requirements of subsection (a) of this section and is otherwise in conformity with the state plan, then it shall approve the application and shall recommend and forward it to the United States Surgeon General.
5. The department by rule shall provide an opportunity for fair hearing and appeal to every applicant who is dissatisfied with any action regarding an application.

History. Acts 1961, No. 414, §§ 15, 16; A.S.A. 1947, §§ 82-341, 82-342; Acts 2019, No. 315, § 1870.

Amendments. The 2019 amendment substituted “rule” for “regulation” in (e).

20-10-221. Construction program — Payment of installments.

The Department of Human Services shall cause to be inspected each construction project approved by the United States Surgeon General. If the inspection warrants, the department shall certify to the United States Surgeon General that work has been performed upon the project or that purchases have been made in accordance with the approved plans and specifications and that payment of an installment of federal funds is due the applicant.

History. Acts 1961, No. 414, § 17; A.S.A. 1947, § 82-343.

20-10-222. Construction program — Federal funds.

1. The Department of Human Services is empowered to receive federal funds in behalf of and transmit them to such applicants.
2. Money received from the United States Government for a construction project shall be deposited with the Treasurer of State as a trust fund. The fund shall be separate and apart from all public funds of the state and shall be used solely for payments due to applicants for work performed or purchases made in carrying out approved projects.
3. Warrants for all payments from the fund shall bear the signature of the Director of the Office of Long-Term Care or his or her agent.
4. The procedure provided in this section for the receipt and disbursement of such funds is not intended to deprive any applicant from receiving federal payments directly if, for any reason, the department or the Treasurer of State is not authorized to receive and transmit federal payments for certain construction projects to certain applicants.

History. Acts 1961, No. 414, § 18; A.S.A. 1947, § 82-344; Acts 2019, No. 389, § 14.

Amendments. The 2019 amendment deleted “designated ‘Hospital and Medical Facilities Construction Fund’” at the end of the first sentence in (b).

20-10-223. Minimum standards for institutions.

1. The Department of Human Services shall require institutions which receive federal aid for construction under the state plan to comply with such minimum standards prescribed by the department as may be promulgated in accordance with the federal act and federal rules and regulations.
2. An institution, or the governing body thereof, shall comply with such minimum standards as may be prescribed by the department under the authority of this section even though federal aid may not be sought or received under §§ 20-10-213 — 20-10-228.

History. Acts 1961, No. 414, § 13; A.S.A. 1947, § 82-339.

20-10-224. License required — Administration by Department of Human Services.

1. No long-term care facility or related institution shall be established, conducted, or maintained in this state without obtaining a license.
2. 1. By properly promulgating rules, the Department of Human Services may provide for the issuance of provisional long-term care facility licenses and long-term care facility licenses, including the licensure of facilities with specialized wings, units, or rooms for dementia residents, those suffering from Alzheimer's disease, and other related conditions.
   2. The licenses shall be effective on a state fiscal year basis and shall expire June 30 of each year, subject to revocation and to annual renewal.
   3. 1. If issued, a provisional license shall be effective upon submission of the application for licensure to the Office of Long-Term Care.
      2. The provisional license shall remain in effect until the issuance of the long-term care facility license.
3. 1. Applicants for long-term care facility licensure shall file applications under oath with the office.
   2. Applications shall be signed by the administrator or the owner of the facility.
   3. Applications shall set forth the full name and address of the facility for which licensure is sought and additional information as the office may require, including affirmative evidence of ability to comply with standards, rules, and regulations as may be lawfully prescribed.
4. No license shall be issued or renewed for any long-term care facility unless the applicant has included in the application the name and such other information required for licensure and disclosure. This requirement, as well as any other requirement determined appropriate by the department, shall be in accordance with the guidelines provided by the department.
5. 1. Whenever ownership of controlling interest in the operation of a facility is sold by the person or persons named in the license to any other person or persons, the buyer shall obtain a license to operate the facility. The buyer shall notify the department of the sale and apply for a license at least thirty (30) days before the completed sale.
   2. Except as provided by the Arkansas Long-Term Care Facility Receivership Law, § 20-10-901 et seq., the seller shall notify the department at least thirty (30) days before the completed sale. The seller shall remain responsible for the operation of the facility until such time as a license is issued to the buyer.
   3. The buyer shall be subject to any plan of correction submitted by the previous licensee and approved by the department.
   4. The seller shall remain liable for all penalties assessed against the facility which are imposed for violations or deficiencies occurring before sale of ownership or operational control.
   5. Before approval of the application for licensure of the buyer, the department shall consider and may deny a license based upon the following:
      1. Whether the administrator, officers, directors, or partners have ever been convicted of a felony;
      2. Whether, within twelve (12) months before the license application, any facility or facilities owned or operated by the applicant or applicants have been found, after final administrative decision, to have committed a Class A violation;
      3. Whether during the three (3) years before the application, the applicant or applicants have had a license revoked; or
      4. Whether the applicant or applicants have demonstrated to the satisfaction of the department that any other facility owned, operated, or administered by the applicant or applicants has been in substantial compliance with the standards as set by applicable state and federal law for the previous twelve-month period before application for licensure.
   6. 1. Except as provided in subdivision (e)(6)(B) of this section, the buyer shall not be issued a license until the buyer provides the department with proof of payment by the buyer to the seller of a sum equal to the annual fee under subsection (i) of this section.
      2. The department shall process a renewal application before issuing a license to a buyer if:
         1. The buyer provides the department with proof of payment by the buyer to the seller of a sum equal to the annual fee under subsection (i) of this section;
         2. The sale occurs between March 1 and July 1 of any year;
         3. The seller applied for or received a renewal of the license; and
         4. The seller paid the annual fee under subsection (i) of this section to the department.
6. 1. Before issuing a license, or approving the operation of any long-term care facility which was not licensed at the time of application or any additional bed capacity of a licensed facility, the department shall consider and may deny a license based upon the criteria established in subdivision (e)(5) of this section.
   2. This subsection is not intended to circumvent or alter the requirements set forth in § 20-8-101 et seq.
7. Except for facilities operated by the State of Arkansas, each long-term care facility shall pay an annual licensure fee in the following amount:
   1. Residential care facilities shall pay an annual fee determined by multiplying five dollars ($5.00) by the total number of licensed resident beds;
   2. Adult day care and adult day healthcare facilities shall pay an annual fee determined by multiplying five dollars ($5.00) by the maximum number of persons the facility can serve; and
   3. All other long-term care facilities shall pay an annual fee determined by multiplying ten dollars ($10.00) by the total licensed resident beds or maximum licensed client population.
8. Annual licensure fees shall be tendered with each application for a new long-term care facility license and with each long-term care facility license renewal application.
9. 1. Annual licensure fees are payable in one (1) sum.
   2. Fees for new licensure applications may be prorated by dividing the total fee by three hundred sixty-five (365) and multiplying the result by the number of days from the date the application is approved through June 30, inclusive.
   3. Applications for licensure renewal shall be delivered, or if mailed shall be postmarked, on or before March 1.
10. Any fee not paid when due shall be delinquent and shall be subject to assessment of a ten-percent penalty.
11. No license or licensure renewal shall be issued unless the annual licensure fee has been paid in full.
12. Licenses shall be issued only for the premises and persons named in the application and shall not be transferable.
13. All funds derived from fees collected pursuant to §§ 20-10-213 — 20-10-228 shall be deposited into the State Treasury and credited to the Division of Economic and Medical Services Administrative Fund to be used for the maintenance and operation of the long-term care facility licensure program.
14. The department shall not require a license for an adult day care program that is excepted from the definition of long-term care facility under § 20-10-101.

History. Acts 1961, No. 414, § 19; 1965, No. 434, § 1; 1971, No. 258, § 2; A.S.A. 1947, § 82-345; Acts 1989, No. 485, § 1; 1989, No. 665, § 1; 1993, No. 1238, §§ 1-3; 1999, No. 1181, § 10; 2005, No. 656, § 1; 2009, No. 216, §§ 1, 2; 2009, No. 357, § 2; 2013, No. 1132, § 5; 2019, No. 315, § 1871.

A.C.R.C. Notes. Health Services Permit Agency, § 20-8-101 et seq.

Amendments. The 2009 amendment by No. 216 inserted (e)(6)(A); and substituted “March 1” for “June 1” in (i).

The 2009 amendment by No. 357 added (n).

The 2013 amendment added subdivision designations in (i); and deleted “quotient, that is, the” following “multiplying” in (i)(2).

The 2019 amendment deleted “and regulations” following “rules” in (b)(1).

20-10-225. Alterations, additions, and new construction of facilities.

1. The Department of Human Services shall prescribe by rule that any licensee or applicant desiring to make specified types of alterations or additions to its facilities or to construct new facilities shall, before commencing such alterations, additions, or new construction, submit plans and specifications for them to the department for preliminary inspection and approval or recommendations with respect to compliance with the rules and standards.
2. From time to time, the Secretary of the Department of Human Services or his or her agent shall inspect each construction project approved by the United States Surgeon General. If the inspection so warrants, the secretary or his or her agent shall certify to the United States Surgeon General that work has been performed upon the project, or purchases have been made, in accordance with the approved plans and specifications, and that payment of an installment of federal funds is due the applicant.

History. Acts 1961, No. 414, § 21; A.S.A. 1947, § 82-347; Acts 1987, No. 143, § 3; 2019, No. 315, § 1872.

Publisher's Notes. Acts 1987, No. 143, § 3, is also codified as § 20-9-217.

Amendments. The 2019 amendment substituted “rule” for “regulation” and “rules” for “regulations” in (a).

20-10-226. Inspections of facilities.

The Department of Human Services shall make such inspections as it may prescribe by rule.

History. Acts 1961, No. 414, § 21; A.S.A. 1947, § 82-347; Acts 2019, No. 315, § 1873.

Amendments. The 2019 amendment substituted “rule” for “regulation”.

20-10-227. Annual report.

The Department of Human Services shall make an annual report of its activities and operations under §§ 20-10-213 — 20-10-228 to the Governor and shall make such information available to the General Assembly as may be requested.

History. Acts 1961, No. 414, § 24; A.S.A. 1947, § 82-350.

20-10-228. Information received by Department of Human Services confidential.

1. Except in a proceeding involving the question of licensing or revocation of a license or as permitted in § 20-10-210(b), information received by the Department of Human Services, through inspection or otherwise, authorized under §§ 20-10-213 — 20-10-228, shall not be disclosed publicly in such a manner as to identify long-term care facility residents, their families, or persons filing complaints.
2. 1. However, in the case of a specific written request by the deputy director of the appropriate division as determined by the Director of the Department of Human Services for information concerning a certain long-term care facility, information obtained during recent inspections of the facility may be supplied in writing to the deputy director.
   2. This exception applies only to facilities providing care for recipients of public welfare and is not to be construed as permitting the exchange of such information on all homes in the state but is specifically limited to those for which the appropriate division as determined by the Director of the Department of Human Services has specific complaints.
   3. These complaints shall be forwarded to the department along with the request for information from the deputy director.
   4. Information received by the deputy director in the manner prescribed in this subsection shall not be disclosed.

History. Acts 1961, No. 414, § 23; 1965, No. 434, § 2; A.S.A. 1947, § 82-349; Acts 1999, No. 1539, § 2; 2001, No. 1774, § 2.

20-10-229. Annual disclosure statement — Requirement.

1. Any person, corporation, partnership, or facility seeking a license or renewal to provide long-term care in this state shall furnish a current annual disclosure statement to all residents upon request or to all prospective residents upon request.
2. The statement shall be filed along with the annual application for licensure by March 1 of each year.
3. The statement shall be on forms and in a format as prescribed by the Department of Human Services and shall include the following information:
   1. The name and business address of the facility and a statement as to whether the facility is a partnership, corporation, or other type of legal entity;
   2. The names and business addresses of the officers, directors, trustees, managing or general partners, or any persons having a five percent (5%) or greater equity or beneficial interest in or of the facility and a description of each person's interest in or occupation with the facility;
   3. A statement as to whether the facility, or any of its officers, directors, trustees, partners, or administrators, before the date of application:
      1. Has ever been convicted of Medicare or Medicaid fraud or felony;
      2. Has ever been convicted of fraud, embezzlement, fraudulent conversion, or misappropriation of property; or
      3. Has had final administrative judgment on any Class A or Class B violations within the last two (2) years;
   4. The location and description of the physical property or property of the facility;
   5. The disclosure statement shall clearly state which services are included in basic care contracts for long-term care and which services are available at or by the facility at extra charge; and
   6. A copy of the contract used by the facility.

History. Acts 1989, No. 664, § 1; 2009, No. 216, § 3.

Amendments. The 2009 amendment substituted “by March 1” for “during July” in (b).

20-10-230. Annual disclosure statement — Filing.

Each facility shall file the completed annual disclosure statement along with its annual license application by March 1 of each year and file a copy of the disclosure statement with the Department of Human Services county office in the county in which the facility is located.

History. Acts 1989, No. 664, § 1; 2009, No. 216, § 4.

Amendments. The 2009 amendment substituted “by March 1” for “during July.”

20-10-231. Annual disclosure statement — Violations.

The failure to provide to any resident a copy of the disclosure statement upon request or to a prospective resident upon request or the failure of any facility to disclose the required information in a timely manner or the failure to file the disclosure statement as required shall be grounds for a Class C violation, pursuant to § 20-10-205.

History. Acts 1989, No. 664, § 1.

20-10-232. Rules, client rights, and sanctions.

1. The Office of Long-Term Care shall promulgate and maintain pursuant to the Arkansas Administrative Procedure Act, § 25-15-201 et seq., separate rules, client rights, and sanctions for intermediate care facilities for individuals with developmental disabilities operations and for other long-term care facilities regulated by the office.
2. Rules which cover all facilities regulated by the office shall be included in each separate set of rules. Changes and updates to each set of rules shall specify which type of rules are being updated or changed.

History. Acts 1991, No. 922, § 19; 1991, No. 1129, § 25; 2019, No. 315, § 1874.

Amendments. The 2019 amendment substituted “Rules” for “Regulations” in the section heading and throughout the section.

20-10-233. [Repealed.]

Publisher's Notes. This section, concerning the oversight subcommittees for community-based care facilities, was repealed by identical Acts 2016 (3rd Ex. Sess.), Nos. 2 and 3, § 39. The section was derived from Acts 1991, No. 922, § 20; 1991, No. 1129, § 26.

20-10-234. [Repealed.]

Publisher's Notes. This section, concerning relicensing bed capacity, was repealed by Acts 2019, No. 389, § 15, effective July 24, 2019. The section was derived from Acts 1997, No. 1025, § 2.

Subchapter 3 — Long-Term Care Facility Advisory Board

20-10-301, 20-10-302. [Repealed.]

Publisher's Notes. These sections, concerning the creation and operation of the Long-Term Care Facility Advisory Board, were repealed by Acts 2017, No. 540, § 39. The sections were derived from the following sources:

20-10-301. Acts 1969, No. 58, §§ 8-10; 1979, No. 28, §§ 7, 8; 1985, No. 884, § 1; 1985, No. 968, § 1; A.S.A. 1947, §§ 6-623 — 6-626, 82-2208 — 82-2210; Acts 1988 (4th Ex. Sess.), No. 18, § 1; 1997, No. 250, § 181; 2015, No. 1100, § 47.

20-10-302. Acts 1969, No. 58, § 11; 1979, No. 28, § 9; 1985, No. 884, § 2; 1985, No. 968, § 2; A.S.A. 1947, § 82-2211.

20-10-303. [Repealed.]

Publisher's Notes. This section, concerning the authority of the Long-Term Care Facility Advisory Board to hear appeals, was repealed by Acts 2005, No. 898, § 4. The section was derived from Acts 1969, No. 58, § 11; 1979, No. 28, § 9; 1985, No. 884, § 2; 1985, No. 968, § 2; A.S.A. 1947, § 82-2211; Acts 1987, No. 981, § 1.

Subchapter 4 — Licensing of Long-Term Care Facility Administrators

Effective Dates. Acts 1969, No. 58, § 17: Jan. 1, 1970.

Acts 1971, No. 721, § 4: Apr. 28, 1971. Emergency clause provided: “It is hereby found and determined by the General Assembly that the present laws of this State relating to the licensing of nursing home administrators are in need of immediate revision in order to clarify such laws and to assure that only competent and qualified persons are licensed as nursing home administrators in this State; that this Act is designed to accomplish these purposes and to thereby assure the citizens of this State that nursing home administrators in this State are competent and qualified for the position they hold. Therefore, an emergency is hereby declared to exist and this Act being necessary for the immediate preservation of the public peace, health and safety shall be in full force and effect from and after its passage and approval.”

20-10-401. Penalty.

1. Any person, partnership, association, or corporation establishing, conducting, managing, or operating any long-term care facility without first obtaining a license as provided by law shall be guilty of a Class A misdemeanor and upon conviction shall be liable to a fine imposed pursuant to a Class A misdemeanor.
2. Each day that a long-term care facility shall operate after a first conviction shall be considered a Class D felony and upon conviction shall be liable to a fine imposed pursuant to a Class D felony.

History. Acts 1985, No. 884, § 4; 1985, No. 968, § 4; A.S.A. 1947, § 82-2234.

A.C.R.C. Notes. Acts 1987, No. 714, § 1, amended Acts 1985, No. 968, § 4, which is codified in this section. However Acts 1987, No. 714, § 2, provided:

“Section 20 of Act 414 of 1961 and Section 4 of Act 884 of 1985 are hereby repealed and this act shall terminate June 30, 1989.”

The effect of this provision on this section, in which Acts 1985, No. 884, § 4, is also codified, is unclear.

20-10-402. License required.

1. It shall be unlawful for any person to act or serve in the capacity of nursing home administrator in this state unless the person has been licensed to do so as authorized in this subchapter.
2. A person who serves as an administrator of a long-term care facility conducted exclusively for persons who rely upon treatment by spiritual means through prayer in accordance with the creed or tenets of a church or religious denomination shall be exempt from subsection (a) of this section and § 20-10-101(1)-(6), § 20-10-203(b), § 20-10-212, §§ 20-10-301 — 20-10-303 [repealed], § 20-10-403, § 20-10-405(b), § 20-10-406, and § 20-10-407.

History. Acts 1969, No. 58, §§ 2, 15; 1971, No. 721, § 1; A.S.A. 1947, §§ 82-2202, 82-2215.

Cross References. Operating institution without a license, §§ 20-9-202, 20-9-203.

20-10-403. Qualifications.

1. The Office of Long-Term Care is vested with the authority and duty to prescribe minimum qualifications for long-term care facility administrators and license persons as long-term care facility administrators who make application for licensure and meet the minimum qualifications as prescribed in this section and by rule of the office.
2. No license shall be issued to a person as a long-term care facility administrator unless:
   1. He or she is at least twenty-one (21) years of age, of good moral character, and of sound physical and mental health;
   2. He or she has:
      1. Satisfactorily completed a course of instruction and training prescribed by the office. The course shall be so designed as to content and administered so as to present sufficient knowledge of the needs properly to be served by long-term care facilities, laws governing the operation of long-term care facilities and the protection of the interests of patients therein, and the elements of good long-term care facility administration;
      2. Presented evidence satisfactory to the office of sufficient education, training, or experience in the foregoing field to administer, supervise, and manage a long-term care facility; or
      3. Participated for one (1) year in an administrator-in-training program approved by the office; and
   3. He or she has passed an examination administered by the office and designed to test for competence in the subject matter referred to in subdivision (b)(2) of this section.

History. Acts 1969, No. 58, § 2; 1975, No. 119, § 2; A.S.A. 1947, § 82-2202; Acts 2019, No. 315, § 1875.

Amendments. The 2019 amendment substituted “rule” for “regulation” in (a).

20-10-404. Application and fees.

1. Any person desiring to be licensed as a nursing home administrator shall make application to the Office of Long-Term Care on forms prescribed by the office and shall furnish such information with the application as shall be required by the office.
2. An applicant shall complete the licensure process within one and one-half (1½) years from the date of application approval for licensure.
3. Each application shall be accompanied by a licensure fee of one hundred dollars ($100), one half (½) of which shall be refunded to the applicant if he or she is refused licensure by the office.
4. This section and §§ 20-10-405 and 20-10-408 only apply to nursing home administrators and are not intended to require administrators in other kinds of long-term care facilities unless provided by rule.

History. Acts 1985, No. 884, § 5; 1985, No. 968, § 5; A.S.A. 1947, § 82-2235; Acts 1987, No. 320, § 1; 2019, No. 315, § 1876.

A.C.R.C. Notes. A purported amendment to § 20-10-401 contains provisions on licensing that may affect this section. See notes to § 20-10-401.

Amendments. The 2019 amendment substituted “rule” for “regulation” in (d).

20-10-405. Renewal.

1. Every active nursing home administrator's license shall be renewed on or before July 1 of each year by paying a fee of one hundred dollars ($100) to the Office of Long-Term Care and by furnishing written documentation that the licensee has attended and accumulated a specific number of continuing education clock hours as established by the office.
2. The fee for those nursing home administrators not actively employed by a nursing home facility as an administrator shall be fifty dollars ($50.00), payable on or before July 1 of each year.
3. If the annual licensure fee in full along with the renewal application and satisfactory documentation of compliance with continuing education requirements is not postmarked or received by the office on or before July 1, the licensee shall be ineligible to perform the duties of nursing home administrator, and the license shall be deemed suspended effective July 2.
4. No request for renewal postmarked or received by the office after July 1 shall be considered unless, in addition to other requirements imposed by law or rule, the licensee tenders a late charge in the amount of fifty dollars ($50.00).
5. Any license not renewed on or before September 1 shall expire effective September 2.

History. Acts 1969, No. 58, § 6; 1975, No. 119, § 5; 1985, No. 884, § 5; 1985, No. 968, § 5; A.S.A. 1947, §§ 82-2206, 82-2235; Acts 1987, No. 320, §§ 1, 2; 1995, No. 469, § 1; 2019, No. 315, § 1877.

Amendments. The 2019 amendment substituted “rule” for “regulation” in (d).

20-10-406. Reciprocity.

1. The Office of Long-Term Care may by rule establish terms and conditions for reciprocity licensure of individuals currently licensed in good standing as long-term care facility administrators in other states.
2. At their option, applicants qualifying for reciprocity licensure may be granted a nonrenewable temporary license not to exceed one hundred twenty (120) days upon condition of payment of a fifty-dollar temporary license fee and upon meeting the terms and conditions established by the office for the temporary license.

History. Acts 1969, No. 58, § 4; 1975, No. 119, § 4; A.S.A. 1947, § 82-2204; Acts 1995, No. 469, § 2; 2019, No. 315, § 1878.

Amendments. The 2019 amendment substituted “rule” for “regulation” in (a).

20-10-407. Denial, revocation, or suspension.

1. The Office of Long-Term Care may refuse to issue or renew a long-term care facility administrator's license or may revoke or suspend the license of a long-term care facility administrator if the office finds that the applicant or licensee does not qualify for licensure or has violated § 20-10-101(1)-(6), § 20-10-203(b), § 20-10-212, §§ 20-10-301 — 20-10-303 [repealed], § 20-10-402, § 20-10-403, § 20-10-405(b), § 20-10-406, and this section or rules of the office relating to the proper administration and management of a long-term care facility.
2. Any denial of the issuance or renewal of a long-term care facility license or a long-term care facility administrator's license or the revocation or suspension of the license shall be after notice and hearing before an impartial hearing officer as provided in § 20-10-208 and shall be subject to judicial review as provided in § 20-10-212.

History. Acts 1969, No. 58, § 7; A.S.A. 1947, § 82-2207; Acts 2005, No. 898, § 5; 2019, No. 315, § 1879.

Amendments. The 2019 amendment substituted “rules” for “regulations” in (a).

20-10-408. Disposition of funds.

1. All funds derived from fees collected pursuant to this subchapter are special revenues and shall be deposited into the State Treasury, there to be credited to the Nursing Home Personnel Training Fund to be utilized by the Office of Long-Term Care for development and implementation of training programs as may be prescribed by the office.
2. Subject to rules as may be implemented by the Chief Fiscal Officer of the State, the disbursing officer for the Department of Human Services may transfer all unexpended funds relative to the licensure of nursing home administrators that pertain to fees collected, as certified by the Chief Fiscal Officer of the State, to be carried forward and made available for expenditures for the same purpose for any following fiscal year.

History. Acts 1987, No. 320, § 1; 2019, No. 315, § 1880.

Amendments. The 2019 amendment deleted “and regulations” following “rules” in (b).

Subchapter 5 — Long-Term Care Network

Preambles. Acts 1981, No. 380 contained a preamble which read:

“Whereas, the State of Arkansas holds the long term care needs of its citizens as a primary concern, and recognizes the development of a coordinated and accessible network of long term care and related community-based services as essential in assuring referral to appropriate services and/or in preventing premature institutionalization; and

“Whereas, several different agencies and departments within State government currently administer funds related to long term care (primarily the Arkansas Department of Health, the Division of Social Services and the Office on Aging and Adult Services);

“Now, therefore … .”

Effective Dates. Acts 1981, No. 380, § 11: Mar. 9, 1981. Emergency clause provided: “It is hereby found and determined by the General Assembly that the development of a coordinated network of long term care and community-based services is essential to the health and welfare of the people of this State, and that immediate steps toward implementation of the provisions of this Act are necessary to establish this coordinated network without undue delay. Therefore, an emergency is hereby declared to exist and this Act being necessary for the immediate preservation of the public health and welfare shall be in full force and effect from and after its passage and approval.”

Acts 1997, No. 179, § 38: Feb. 17, 1997. Emergency clause provided: “It is hereby found and determined by the General Assembly that Act 10 of the First Extraordinary Session of 1995 abolished the Joint Interim Committee on Public Health, Welfare, and Labor and in its place established the House Interim Committee and Senate Interim Committee on Public Health, Welfare, and Labor; that various sections of the Arkansas Code refer to the Joint Interim Committee on Public Health, Welfare, and Labor and should be corrected to refer to the House and Senate Interim Committees on Public Health, Welfare, and Labor; that this act so provides; and that this act should go into effect immediately in order to make the laws compatible as soon as possible. Therefore, an emergency is declared to exist and this act being immediately necessary for the preservation of the public peace, health and safety shall become effective on the date of its approval by the Governor. If the bill is neither approved nor vetoed by the Governor, it shall become effective on the expiration of the period of time during which the Governor may veto the bill. If the bill is vetoed by the Governor and the veto is overridden, it shall become effective on the date the last house overrides the veto.”

20-10-501. Definitions.

As used in this subchapter:

1. “Committees” means the House Committee on Public Health, Welfare, and Labor and the Senate Committee on Public Health, Welfare, and Labor or appropriate subcommittees thereof to whom the state agencies in the long-term care network will report the progress of this effort;
2. “Long-term care and related community-based services” means preventive, diagnostic, therapeutic, rehabilitative, and maintenance services available in the home and a variety of protected environments, including institutions, provided to persons, regardless of age, whose capabilities have been impaired by physical, mental, or emotional disability; and
3. “State agencies” means the Department of Human Services and any other state agency which administers funds for long-term care and related community-based services.

History. Acts 1981, No. 380, § 1; A.S.A. 1947, § 82-2226; Acts 1997, No. 179, § 24.

20-10-502. Coordination of state and nonstate agencies.

1. The state agencies which administer funds for long-term care shall work together to achieve a coordinated and accessible network of long-term care and related community-based services, utilizing an orderly and effective interagency referral system.
2. The state agencies shall develop procedures and guidelines to assure that coordination between state agencies in the long-term care network will take place.
3. Nonstate agencies shall be encouraged to participate in the long-term care network.
4. Any nonstate agency which receives state funds related to long-term care services shall be required to abide by the policies and procedures of the long-term care network.

History. Acts 1981, No. 380, § 2; A.S.A. 1947, § 82-2227.

20-10-503. Interagency agreements.

The state agencies shall work out formalized agreements among themselves that will set forth all the elements of this plan.

History. Acts 1981, No. 380, § 3; A.S.A. 1947, § 82-2228.

20-10-504. Public information campaign.

The state agencies shall carry out a public information campaign to inform the citizens of Arkansas about this network of services.

History. Acts 1981, No. 380, § 4; A.S.A. 1947, § 82-2229.

20-10-505. Demonstration projects for assessment agencies.

1. State agencies shall establish a demonstration project in a limited number of counties in order to develop a comprehensive long-term care assessment system.
2. This project shall develop the role of assessment agencies for the long-term care network.
3. These assessment agencies shall not be engaged in the provision of services but shall perform an assessment function to measure the client's total needs in order to refer the client to the appropriate level of care available.

History. Acts 1981, No. 380, § 5; A.S.A. 1947, § 82-2230.

20-10-506. Reports.

1. The state agencies shall collect and report management and caseload information to the appropriate legislative committees on a quarterly basis.
2. Each agency shall identify to the committees all agency funds and personnel involved in the delivery of long-term care and related community-based services.

History. Acts 1981, No. 380, § 6; A.S.A. 1947, § 82-2231; Acts 1997, No. 179, § 25.

20-10-507. Training program for home health aide providers.

The state agencies shall develop a plan for training home health aide providers.

History. Acts 1981, No. 380, § 7; A.S.A. 1947, § 82-2232.

20-10-508. Interagency transfers of funds.

1. The Department of Health, the Department of Human Services, and any other state agency which administers funds and appropriations for long-term care and related community-based services may transfer funds and appropriations among themselves in such amounts as they deem necessary to carry out the intent of this subchapter.
2. The transfers are to be made upon the request of the state agency, but only after having sought and received the advice of the committees, by the Chief Fiscal Officer of the State.

History. Acts 1981, No. 380, § 8; A.S.A. 1947, § 82-2233; Acts 1997, No. 179, § 26.

Subchapter 6 — Long-Term Care Ombudsman Act

20-10-601. Title.

This subchapter shall be known and may be cited as the “Long-Term Care Ombudsman Act”.

History. Acts 1987, No. 252, § 1.

20-10-602. Ombudsman program.

The Division of Aging, Adult, and Behavioral Health Services of the Department of Human Services shall establish and administer an ombudsman program in accordance with the Older Americans Act, 42 U.S.C. § 3001 et seq., as amended, and all applicable federal and state laws, including the Arkansas Administrative Procedure Act, § 25-15-201 et seq.

History. Acts 1987, No. 252, § 2; 2017, No. 913, § 57.

Amendments. The 2017 amendment substituted “Division of Aging, Adult, and Behavioral Health Services” for “Division of Aging and Adult Services”.

20-10-603. Access to patients.

No ombudsman shall be denied access to any patient or resident in a long-term care facility during any period of operation of the facility.

History. Acts 1987, No. 252, § 3.

Subchapter 7 — Long-Term Care Aide Training Act

Effective Dates. Acts 1987, No. 689, § 8: Apr. 7, 1987. Emergency clause provided: “It is hereby found and determined by the General Assembly that the adequacy of personal care for Arkansas residents in long term care facilities could be assured through a formalized training program; that the training program should be implemented as soon as possible to preserve the public peace, health, and safety. Therefore, an emergency is declared to exist and this Act being necessary for the immediate preservation of the public peace, health, and safety shall be in full force and effect from and after its passage and approval.”

Acts 2005, No. 2191, § 11: Apr. 13, 2005. Emergency clause provided: “It is found and determined by the General Assembly of the State of Arkansas that various long-term care facilities are operating in this state without having obtained a license; that there is no state oversight or protection for the vulnerable residents in these facilities; and that there is no way of ensuring that the facilities properly treat and protect these residents under state long-term care laws. Therefore, an emergency is declared to exist and this act being immediately necessary for the preservation of the public peace, health, and safety shall become effective on: (1) The date of its approval by the Governor; (2) If the bill is neither approved nor vetoed by the Governor, the expiration of the period of time during which the Governor may veto the bill; or (3) If the bill is vetoed by the Governor and the veto is overridden, the date the last house overrides the veto.”

20-10-701. Title.

This subchapter shall be known and may be cited as the “Long-Term Care Aide Training Act”.

History. Acts 1987, No. 689, § 1.

20-10-702. Definitions.

As used in this subchapter:

1. “Long-term care facility” means a nursing home, a residential care facility, an assisted living facility, an adult day-care facility, or any other facility which provides long-term medical or personal care; and
2. “Primary instructor” means a registered nurse who:
   1. 1. Is licensed in this state; or
      2. Holds a multistate privilege to practice if the registered nurse moves from a state that has joined the Interstate Nurse Licensure Compact, § 17-87-601 et seq., to Arkansas and meets all requirements for licensure in Arkansas;
   2. Does not have any disciplinary action regarding his or her license by the licensing entity or authority; and
   3. 1. Possesses a minimum of two (2) years' general nursing experience as a registered nurse including at least one (1) year of long-term care nursing services in a nursing facility setting within the last five (5) years.
      2. As used in this section, “general nursing experience” may include without limitation employment in a nursing assistant education program or employment in or supervision of nursing students in a nursing facility or unit, geriatrics department excluding a geriatric psychiatry department, long-term acute care hospital, home healthcare, hospice care, or other long-term care setting.

History. Acts 1987, No. 689, § 5; 2005, No. 2191, § 6; 2019, No. 1059, § 1.

Amendments. The 2019 amendment substituted “Definitions” for “Definition” in the section heading; added the designation (1); added (2); and made stylistic changes.

20-10-703. Exemptions.

Students who have satisfactorily completed a nursing assistant or aide training program in either a public or private proprietary school licensed by the State of Arkansas are excluded from this subchapter since they will already have attained the skills needed to serve as aides in long-term care facilities.

History. Acts 1987, No. 689, § 4.

20-10-704. Training program.

The Office of Long-Term Care shall establish a training program to be completed by all aides in long-term care facilities who provide personal care to residents.

History. Acts 1987, No. 689, § 2.

20-10-705. Rules.

1. The Office of Long-Term Care shall promulgate rules necessary to implement an aide training program for all long-term care facilities in this state, to prescribe in-service training programs, and to enforce compliance with those programs.
2. 1. The rules shall require training programs to:
      1. Provide no fewer than ninety (90) clock hours of training;
      2. Include in those ninety (90) clock hours no fewer than fifteen (15) clock hours of training specific to Alzheimer's disease and related dementia; and
      3. Have only one (1) primary instructor for each course.
   2. The training programs required under this subsection shall take effect only if funds are available.
   3. The training program established under this section shall be known as the “Barbara Broyles Training Program”.

History. Acts 1987, No. 689, § 3; 2005, No. 1184, § 1; 2019, No. 315, § 1881; 2019, No. 1059, § 2.

A.C.R.C. Notes. Acts 2019, No. 1059, § 2 specifically amended subsection (b) of this section as amended by Acts 2019, No. 315, § 1881.

Amendments. The 2019 amendment by No. 315 substituted “Rules” for “Regulations” in the section heading and throughout the section.

The 2019 amendment by No. 1059 added (b)(1)(C).

20-10-706. [Repealed.]

Publisher's Notes. This section, concerning the requirement of personal care and home-health aide services to complete a training program, and registration, certification and exemptions, was repealed by Acts 1992 (1st Ex. Sess.), No. 1, § 6. The section was derived from Acts 1991, No. 922, § 17.

Subchapter 8 — Home Healthcare Services

Effective Dates. Acts 1995, No. 1321, § 5: Apr. 14, 1995. Emergency clause provided: “It is hereby found and determined by the General Assembly that home health care services should be dealt with by the private sector obtaining licenses or permits of approval from any agency of the state; that this act so provides; and this act should go into effect as soon as possible in order to maximize home health care services throughout this state. Therefore, an emergency is hereby declared to exist and this act being necessary for the immediate preservation of the public peace, health and safety shall be in full force and effect from and after its passage and approval.”

Acts 1999, No. 1508, § 19: Apr. 15, 1999. Emergency clause provided: “It is hereby found and determined by the Eighty-second General Assembly that this act makes various technical corrections in the Arkansas Code; that this act further clarifies the law to provide that the Arkansas Code Revision Commission may correct errors resulting from enactments of prior sessions; and that this act should go into effect immediately in order to be applicable during the codification process of the enactments of this regular session. Therefore, an emergency is declared to exist and this act being immediately necessary for the preservation of the public peace, health and safety shall become effective on the date of its approval by the Governor. If the bill is neither approved nor vetoed by the Governor, it shall become effective on the expiration of the period of time during which the Governor may veto the bill. If the bill is vetoed by the Governor and the veto is overridden, it shall become effective on the date the last house overrides the veto.”

20-10-801. Definitions.

As used in this subchapter:

1. “Agency” means any person, partnership, association, corporation, or other organization, whether public or private, proprietary or nonprofit;
2. “Class A license” means that the applicant is at the time of filing an application a Medicare-certified home health agency. If the applicant is not at the time of filing its application a certified home health agency, it shall be in the process of receiving its certification from the Center for Medicare & Medicaid Services;
3. “Class B license” means that the application shall show proof of the services provided and the geographical territory in which those services have been provided as of July 20, 1987, and that the applicant shall have requested a survey for the purpose of confirming the services provided and territory covered;
4. “Division” means the Division of Health Facilities Services;
5. “Home healthcare services” means the providing or coordinating of acute, restorative, rehabilitative, maintenance, preventive, or health promotion services through professional nursing or by other therapeutic services such as physical therapy, occupational therapy, speech therapy, home health aide, or personal services in a client's residence;
6. “Home healthcare services agency” means an agency licensed to provide home healthcare services;
7. “Place of business” means any office of a home health agency including subunits;
8. “Residence” means a place where a person resides, including a home, nursing home, or convalescent home for the disabled or aged; and
9. “Subunit” means an organization of an agency that provides home healthcare services and which serves patients in a geographic area different from that of the agency.

History. Acts 1987, No. 956, § 1.

20-10-802. Exceptions from licensing requirements.

The following persons are not required to be licensed under § 20-10-807:

1. A physician, dentist, registered nurse, or physical therapist who is currently licensed under the laws of this state who provides home health services only to a patient as a part of his or her private office practice when the services are incidental to the office practice;
2. The following healthcare professionals providing home healthcare services as a sole practitioner:
   1. A registered nurse;
   2. A licensed vocational nurse;
   3. A physical therapist;
   4. An occupational therapist;
   5. A speech therapist;
   6. A medical social worker; or
   7. Any other healthcare professional as determined by the Department of Health;
3. A nonprofit registry operated by a national or state professional association or society of licensed healthcare practitioners, or a subdivision thereof, that operates solely as a clearinghouse to put consumers in contact with licensed healthcare practitioners who will give care in a patient's residence and that neither maintains the official patient records nor directs patient services;
4. An individual whose permanent residence is in the patient's residence;
5. An employee of a person holding a license under this subchapter who provides home healthcare services only as an employee of the licensed person and who receives no benefit for providing home healthcare services other than wages from the employer;
6. A home, nursing home, convalescent home, or other institution for individuals with disabilities or individuals who are elderly that provides health services only to residents of the home or institution;
7. A person who provides one (1) health service through a contract with a person licensed;
8. A durable medical equipment supply company;
9. A pharmacy or wholesale medical supply company that furnishes those services that relate to drugs and supplies to persons in their homes;
10. A hospital or other licensed healthcare facility serving only inpatient residents;
11. A visiting nurse service or home aide service constructed by and for the adherents of a religious denomination for the purpose of providing services for those who depend upon spiritual means through prayer alone for healing; and
12. Persons providing services to one (1) or more individuals with intellectual or other developmental disabilities, as defined in § 20-48-101, under a license or certificate from the Division of Developmental Disabilities Services.

History. Acts 1987, No. 956, § 2; 2003, No. 1783, § 1; 2019, No. 389, § 16; 2019, No. 1035, § 12.

A.C.R.C. Notes. Acts 2019, No. 389, § 88, provided: “CONSTRUCTION AND LEGISLATIVE INTENT.

It is the intent of the General Assembly that:

“(1) The enactment and adoption of this act shall not expressly or impliedly repeal an act passed during the regular session of the Ninety-Second General Assembly;

“(2) To the extent that a conflict exists between an act of the regular session of the Ninety-Second General Assembly and this act:

“(A) The act of the regular session of the Ninety-Second General Assembly shall be treated as a subsequent act passed by the General Assembly for the purposes of:

“(i) Giving the act of the regular session of the Ninety-Second General Assembly its full force and effect; and

“(ii) Amending or repealing the appropriate parts of the Arkansas Code of 1987; and

“(B) Section 1-2-107 shall not apply; and

“(3) This act shall make only technical, not substantive, changes to the Arkansas Code of 1987”.

Amendments. The 2019 amendment by No. 389, in (12), deleted “developmentally disabled” preceding “persons” and inserted “with a developmental disability”.

The 2019 amendment by No. 1035 substituted “one (1) or more individuals with intellectual or other developmental disabilities” for “one (1) or more developmentally disabled persons” in (12).

20-10-803. Penalties.

1. 1. Any person who violates any provision of this subchapter or rules lawfully promulgated under this subchapter shall be guilty of a violation.
   2. Upon conviction, that person shall be liable to a fine of not less than twenty-five dollars ($25.00) nor more than one hundred dollars ($100) for the first offense and not less than one hundred dollars ($100) nor more than five hundred dollars ($500) for each subsequent offense.
2. Each day that the person performs home healthcare services after a first conviction shall be considered a subsequent offense.

History. Acts 1987, No. 956, § 5; 2005, No. 1994, § 111; 2019, No. 315, § 1882.

Amendments. The 2019 amendment substituted “rules” for “regulations” in (a)(1).

20-10-804, 20-10-805. [Repealed.]

Publisher's Notes. These sections, concerning the Home Health Care Service Agency Advisory Council, its operation, powers and duties, were repealed by Acts 2017, No. 540, § 40. The sections were derived from the following sources:

20-10-804. Acts 1987, No. 956, § 8.

20-10-805. Acts 1987, No. 956, § 8.

20-10-806. Administration — Rules and standards.

1. This subchapter shall be administered by the Division of Health Facilities Services.
2. 1. The State Board of Health shall adopt, promulgate, and enforce such rules and standards as may be necessary for the accomplishment of the purposes of this subchapter.
   2. The rules and standards shall be amended or rescinded from time to time by the board as may be in the public interest, after first complying with the Arkansas Administrative Procedure Act, § 25-15-201 et seq.
   3. Rules under this subchapter shall:
      1. 1. Require that a qualified supervisor shall establish the frequency of in-person supervisory visits as part of the patient's plan of care based on the specific needs of the patient and the recommendations of the registered nurse.
         2. The frequency of in-person visits shall be at least annually.
         3. 1. A qualified supervisor shall be a licensed nurse or have completed two (2) years of full-time study at an accredited institution of higher education.
            2. An individual who has a high school diploma or general equivalency diploma may substitute one (1) year of full-time employment in a supervisory capacity in a healthcare facility or community-based agency for one (1) year at an institution of higher education; and
      2. Not require:
         1. A registered nurse to visit a patient every sixty-two (62) days to supervise services; or
         2. A branch office of a home healthcare services agency that only provides unskilled home healthcare services to be within a one-hundred-mile radius of a patient's home.

History. Acts 1987, No. 956, § 3; 2019, No. 315, § 1883; 2019, No. 811, § 2.

A.C.R.C. Notes. Acts 2019, No. 811, § 4, provided: “Legislative intent. It is the intent of the General Assembly to address and require amendments to rules concerning nonskilled, nonmedical personal care and private care services without making any alternations to skilled home healthcare services or the provision of medical home care services”.

Publisher's Notes. Acts 2019, No. 811, § 2 specifically amended subsection (b) of this section as amended by Acts 2019, No. 315.

Amendments. The 2019 amendment by No. 315 deleted “regulations” following “rules” twice in (b).

The 2019 amendment by No. 811 redesignated (b) as (b)(1) and (2); deleted “modified” following “shall be” in (b)(2); and added (b)(3).

20-10-807. License required.

It shall be unlawful for any agency to provide home healthcare services unless licensed pursuant to this subchapter.

History. Acts 1987, No. 956, § 4.

20-10-808. Application for license — Temporary license.

1. An applicant for a license to provide home healthcare services shall:
   1. File a written application on a form prescribed by the Division of Health Facilities Services;
   2. File with the application the name of the owner of the agency or a list of names of persons who own an interest in the agency and a list of any businesses with which the agency subcontracts and in which the owner or owners of the agency hold as much as five percent (5%) of the ownership;
   3. Establish a place of business within the State of Arkansas that maintains home healthcare services records and directs patient services;
   4. Cooperate with any inspections the division may require for a license and comply with rules and standards promulgated under this subchapter; and
   5. Pay to the division a license fee as prescribed by § 20-10-812.
2. In addition to the requirements listed in subsection (a) of this section for new and existing agencies providing home healthcare services on July 20, 1987, those agencies shall furnish the following information for a Class A or Class B license:
   1. For a Class A license, if the applicant is at the time of filing an application a Medicare-certified home health agency, the applicant shall provide proof of its compliance with federal conditions of participation. If the applicant is not at the time of filing its application a certified home health agency, it shall be in the process of receiving its certification from the Center for Medicare & Medicaid Services; and
   2. For a Class B license, the applicant shall show proof of the home healthcare services provided and the geographical territory in which those home healthcare services have been provided as of July 20, 1987, and it shall have requested a survey for the purposes of confirming the home healthcare services provided and the territory covered.
3. The Director of the Division of Health Facilities Services may issue a temporary license to an applicant for a period not to exceed six (6) months.

History. Acts 1987, No. 956, §§ 3, 9; 2019, No. 315, § 1884.

Amendments. The 2019 amendment substituted “rules” for “regulations” in (a)(4).

20-10-809. Issuance of licenses.

1. 1. The Director of the Division of Health Facilities Services shall issue licenses for the operation of home healthcare services agencies which are found to comply with this subchapter and with the rules of the State Board of Health.
   2. The director shall also issue licenses for the operation of subunits of a home healthcare services agency.
2. Licenses shall be issued to the entity and persons listed in the application for licensure and shall not be transferable.

History. Acts 1987, No. 956, § 4; 2019, No. 315, § 1885.

Amendments. The 2019 amendment substituted “rules” for “regulations” in (a)(1).

20-10-810. Denial, suspension, or revocation of license.

The Director of the Division of Health Facilities Services may deny, suspend, or revoke licensure on any of the following grounds:

1. Violation of this subchapter or the rules lawfully promulgated under this subchapter; and
2. Permitting, aiding, or abetting the commission of any unlawful act in connection with the operation of the home healthcare services agency.

History. Acts 1987, No. 956, § 4; 2019, No. 315, § 1886.

Amendments. The 2019 amendment deleted “and regulations” following “rules” in (1).

20-10-811. [Repealed.]

Publisher's Notes. This section, concerning confidential information, was repealed by Acts 2019, No. 1042, § 1, effective July 24, 2019. The section was derived from Acts 1987, No. 956, § 6.

20-10-812. Fees.

1. 1. The Division of Health Facilities Services may levy and collect a fee for the issuance of an annual license to a home healthcare services agency or a subunit of a home healthcare services agency. The license fee for a home healthcare services agency shall be an annual fee of one thousand dollars ($1,000), and the fee for a subunit shall be an annual fee of one hundred dollars ($100).
   2. The fees collected under this subsection shall be deposited into the Health Facility Services Revolving Fund.
2. Except for those fees set forth in subsection (a) of this section, all fees levied and collected under this subchapter shall be special revenues and shall be deposited into the State Treasury and credited to the Public Health Fund.
3. Subject to those rules that may be implemented by the Chief Fiscal Officer of the State, the disbursing officer for the Department of Health may transfer all unexpended funds relative to this subchapter that pertain to fees collected except for those collected under subsection (a) of this section, as certified by the Chief Fiscal Officer of the State, to be carried forward and made available for expenditures for the same purposes for any following fiscal year.

History. Acts 1987, No. 956, § 7; 1997, No. 574, § 2; 1999, No. 1508, § 9; 2019, No. 315, § 1887.

Amendments. The 2019 amendment deleted “and regulations” following “rules” in (c).

20-10-813. Transfer of licenses and permits upon dissolution.

Upon the dissolution of any corporation which on April 14, 1995, is licensed to provide home healthcare services, the Department of Health, the Health Services Permit Agency, the Health Services Permit Commission, and any other agency involved may transfer the dissolved corporation's licenses and permits of approval to a stockholder of the dissolved corporation, and that stockholder may continue to perform home healthcare services under the transferred license and permit of approval.

History. Acts 1995, No. 1321, § 1; 2001, No. 1800, § 16.

Subchapter 9 — Arkansas Long-Term Care Facility Receivership Law

Publisher's Notes. Acts 1988 (4th Ex. Sess.), No. 3, § 2, and No. 13, § 2, provided that if any part of this subchapter is found to conflict with federal requirements which are a prescribed condition to the allocation of federal funds to the state, the conflicting part of this subchapter is declared to be inoperative solely to the extent of the conflict, and such finding or determination shall not affect the operation of the remainder of this subchapter.

Effective Dates. Acts 1988 (4th Ex. Sess.), No. 3, § 4 and No. 13, § 4: July 15, 1988. Emergency clause provided: “It is hereby found and determined by the General Assembly that during recent months, certain inadequacies in the continuum of health care for the older citizens of this State have been brought to the attention of the General Assembly; that this Act is necessary to assure each citizen of this State in need of long-term care that a high quality of care at affordable cost will be provided; that the older citizenry of this State deserve the best possible care; that the immediate passage of this Act is essential to the health, welfare and safety of the citizens of the State of Arkansas and to avoid irreparable harm upon the proper administration of an essential government program. Therefore, an emergency is hereby declared to exist and this act being necessary for the preservation of the public peace, health and safety shall be in full force and effect from and after its passage and approval.”

Acts 2019, No. 910, § 6346(b): July 1, 2019. Emergency clause provided: “It is found and determined by the General Assembly of the State of Arkansas that this act revises the duties of certain state entities; that this act establishes new departments of the state; that these revisions impact the expenses and operations of state government; and that the sections of this act other than the two uncodified sections of this act preceding the emergency clause titled ‘Funding and classification of cabinet-level department secretaries’ and ‘Transformation and Efficiencies Act transition team’ should become effective at the beginning of the fiscal year to allow for implementation of the new provisions at the beginning of the fiscal year. Therefore, an emergency is declared to exist, and Sections 1 through 6343 of this act being necessary for the preservation of the public peace, health, and safety shall become effective on July 1, 2019”.

20-10-901. Title.

This subchapter may be known as the “Arkansas Long-Term Care Facility Receivership Law”.

History. Acts 1988 (4th Ex. Sess.), No. 3, § 1; 1988 (4th Ex. Sess.), No. 13, § 1.

20-10-902. Purpose.

It is the purpose of this subchapter to develop a mechanism whereby the concept of receivership can be utilized for the protection of residents in long-term care facilities. It is the intent of the General Assembly that receivership shall be a remedy of last resort when all other methods of remedy have failed or when the implementation of other remedies would be futile. It is not the intent of this subchapter to circumvent the Health Services Permit Program of the Health Services Permit Commission. No court or administrative agency shall interpret the contents of this subchapter to allow the transfer of beds or the license of a facility under receivership without approval of the commission as required by § 20-8-101 et seq.

History. Acts 1988 (4th Ex. Sess.), No. 3, § 1; 1988 (4th Ex. Sess.), No. 13, § 1; 2001, No. 1800, § 17.

20-10-903. Definitions.

As used in this subchapter:

1. “Administrator” means a long-term care facility administrator as defined in § 20-10-101;
2. “Emergency” means a situation, a physical condition, or one (1) or more practices, methods, or operations which threaten the health, security, or welfare of residents;
3. “Facility” means a long-term care facility which is required to be licensed under § 20-10-224;
4. “Habitual violation” means a violation of state or federal law which, due to its repetition, presents a reasonable likelihood of serious physical or mental harm to residents;
5. “Licensee” means any person or any other legal entity that is licensed or required to be licensed to operate a facility;
6. “Owner” means the holder of the title to the real estate in which the facility is maintained;
7. “Resident” means any person who lives in and receives services or care in a long-term care facility; and
8. “Substantial violation” means a violation of state or federal law which presents a reasonable likelihood of serious physical or mental harm to residents.

History. Acts 1988 (4th Ex. Sess.), No. 3, § 1; 1988 (4th Ex. Sess.), No. 13, § 1.

20-10-904. Grounds for appointment.

The following circumstances shall be grounds for the appointment of a receiver to operate a long-term care facility:

1. An emergency exists in a facility which threatens the health, security, or welfare of residents;
2. A facility is in substantial or habitual violation of the standards of health, safety, or resident care established under state rules or federal regulations to the detriment of the welfare of the residents;
3. A facility intends to close but has not arranged at least thirty (30) days before closure for the orderly transfer of its residents;
4. The facility is insolvent; and
5. The Department of Human Services has suspended, revoked, or refused to renew the existing license of the facility.

History. Acts 1988 (4th Ex. Sess.), No. 3, § 1; 1988 (4th Ex. Sess.), No. 13, § 1; 2019, No. 315, § 1888.

Amendments. The 2019 amendment inserted “rules” in (2).

20-10-905. Petition for receivership.

1. The Department of Human Services, Attorney General, or prosecuting attorney or duly appointed deputy prosecuting attorney of the district in which the facility is located may file a complaint in the circuit court of the county in which the facility is located requesting the appointment of a receiver.
2. A complaint for appointment of a receiver pursuant to this subchapter shall have precedence and priority over any civil case pending in the circuit court in which the complaint is filed.
3. The court shall hold a hearing on the complaint within five (5) days of the filing of the complaint.
4. The complaint and notice of hearing shall be served on the owner and administrator or licensee of the facility. In cases when the department is not the plaintiff in the action, a copy of the complaint and notice shall be forwarded by mail to the Secretary of the Department of Human Services by the plaintiff.

History. Acts 1988 (4th Ex. Sess.), No. 3, § 1; 1988 (4th Ex. Sess.), No. 13, § 1; 2019, No. 910, § 5184.

Amendments. The 2019 amendment substituted “Secretary of the Department of Human Services” for “Director of the Department of Human Services” in (d).

20-10-906. Hearing on receivership.

The court shall appoint a receiver if it finds that any one (1) of the grounds for appointment set forth in § 20-10-904 is satisfied.

History. Acts 1988 (4th Ex. Sess.), No. 3, § 1; 1988 (4th Ex. Sess.), No. 13, § 1.

20-10-907. Emergency appointment.

1. If the complaint filed under § 20-10-905 is filed by the Department of Human Services and alleges that grounds set out in § 20-10-904(1) or § 20-10-904(2) exist within a facility and is accompanied by a verified affidavit setting forth facts which would constitute such a ground, a temporary receiver shall be appointed with or without notice to the owner, licensee, or administrator.
2. The temporary appointment of a receiver without notice to the owner, licensee, or administrator may be made only if the court is satisfied that the department has made a diligent attempt to provide reasonable notice under the circumstances. The delivery of a copy of the complaint to the facility upon filing shall constitute reasonable notice for issuance of a temporary receivership order by the court.
3. Upon appointment of a temporary receiver, the department shall proceed immediately to obtain service as provided in § 20-10-905(d).
4. If the department does not proceed with the complaint, the court shall dissolve the temporary receivership after ten (10) days.

History. Acts 1988 (4th Ex. Sess.), No. 3, § 1; 1988 (4th Ex. Sess.), No. 13, § 1; 2007, No. 827, § 152.

20-10-908. Qualifications of receiver.

1. The circuit court may appoint any licensed nursing home administrator or any qualified person as a receiver who does not have a conflict of interest.
2. The Department of Human Services shall maintain a list of qualified persons to be furnished to the court. Preference shall be given to persons with experience in delivery of healthcare services and operation of long-term care facilities.
3. No person may be considered to be qualified to be a receiver who:
   1. Is the owner, licensee, or administrator of the facility;
   2. Is affiliated with the facility;
   3. Has a financial interest in the facility; or
   4. Has owned or operated a facility that has been ordered into receivership.

History. Acts 1988 (4th Ex. Sess.), No. 3, § 1; 1988 (4th Ex. Sess.), No. 13, § 1.

20-10-909. Duties of receiver.

The receiver appointed pursuant to this subchapter:

1. Shall operate the facility in such a manner as to assure safety and adequate health care for the residents;
2. Shall receive and expend in a reasonable and prudent manner the revenues of the facility;
3. May hire, direct, manage, and discharge any employees, including the administrator of the facility;
4. Shall be entitled to and shall take possession of all property or assets of residents which are in the possession of the licensee or operator of the facility. The receiver shall preserve all property, assets, and records of residents of which the receiver takes possession;
5. 1. May contract for such outside services as may be needed for the operation of the facility.
   2. Any contract for outside services in excess of three thousand dollars ($3,000) shall be approved by the court;
6. Shall pay commercial creditors of the facility determined by the receiver to be valid;
7. 1. May do all things necessary and proper to maintain and operate the facility in accordance with sound fiscal policies.
   2. The receiver shall take such action as is reasonably necessary to protect or conserve the assets or property of which the receiver takes possession and may use such assets or property only in the performance of the powers and duties set out in this section;
8. Shall conduct the day-to-day business operations of the facility;
9. 1. Shall correct or eliminate any deficiency in the structure or furnishings of the facility which endangers the safety or health of residents while they remain in the facility, provided the total cost of correction does not exceed three thousand dollars ($3,000).
   2. The circuit court may order expenditures for this purpose in excess of three thousand dollars ($3,000) upon application from the receiver, after notice to the owner and hearing;
10. Shall collect incoming payments from all sources and apply them to the costs incurred in the performance of his or her functions as receiver, including the compensation of the receiver;
11. Shall honor existing leases, mortgages, chattel mortgages, and security interests determined by the receiver to be valid;
12. Shall remedy violations of federal and state rules and regulations governing the operation of the facility;
13. May close the facility or negotiate with the owners for the sale of the facility upon approval of the court;
14. Shall give each resident of the facility and the family representative of each resident notice of the receivership;
15. 1. May hire consultants or undertake any studies of the facility he or she deems appropriate.
    2. Any expenditure under this subdivision (15) in excess of three thousand dollars ($3,000) shall be approved by the court.
    3. “Consultants” excludes the owner, licensee, administrator, persons affiliated with the facility, persons with a financial interest in the facility, and persons who have owned or operated a facility that has been ordered into receivership unless approved by the court; and
16. Shall file reports concerning the receivership and expenditures with the court in such frequency as the court deems appropriate and shall forward a copy of each report to the owner and administrator or licensee of the facility.

History. Acts 1988 (4th Ex. Sess.), No. 3, § 1; 1988 (4th Ex. Sess.), No. 13, § 1; 2019, No. 315, § 1889.

Amendments. The 2019 amendment inserted “rules and” in (12).

20-10-910. Compensation of receiver.

1. The circuit court shall set a reasonable compensation to include salary and reasonable expenses for the receiver to be paid as a necessary expense of the facility under the receivership. Reasonable expenses may include charges for a liability insurance policy covering negligence of the receiver and employees of the facility for the duration of the receivership.
2. If the receiver does not have sufficient funds to pay the salary from the revenues of the facility, the receiver may petition the court for permission to file a claim with the Department of Human Services for payment from the Long-Term Care Facility Receivership Fund Account as established in § 20-10-916.

History. Acts 1988 (4th Ex. Sess.), No. 3, § 1; 1988 (4th Ex. Sess.), No. 13, § 1.

20-10-911. Duration of receivership.

1. The receiver shall be appointed for an initial period of not more than six (6) months.
2. The initial six-month period may be extended for an additional period of ninety (90) days with approval of the circuit court upon a showing of good cause.

History. Acts 1988 (4th Ex. Sess.), No. 3, § 1; 1988 (4th Ex. Sess.), No. 13, § 1.

20-10-912. Bond of receiver.

The circuit court may require a receiver to post a bond, which may include provision for costs and attorney's fees, upon breach of fiduciary duty.

History. Acts 1988 (4th Ex. Sess.), No. 3, § 1; 1988 (4th Ex. Sess.), No. 13, § 1.

20-10-913. Automatic stay.

1. No person or court of this state shall impede the operation of a receivership created under this subchapter.
2. For a sixty-day period subsequent to the appointment of a receiver, there shall be an automatic stay of any action that would interfere with the functioning of the facility, including, but not limited to, cancellation of insurance policies executed by the licensee, termination of utility services, executions, attachments or setoffs, and repossession of equipment used in the facility.

History. Acts 1988 (4th Ex. Sess.), No. 3, § 1; 1988 (4th Ex. Sess.), No. 13, § 1.

20-10-914. Accounting for funds.

Within thirty (30) days after termination, the receiver shall file with the court a complete accounting of all property of which the receiver has taken possession, of all funds collected, and of the expenses of the receivership.

History. Acts 1988 (4th Ex. Sess.), No. 3, § 1; 1988 (4th Ex. Sess.), No. 13, § 1.

20-10-915. Alternative procedure.

1. 1. In lieu of bringing an action under this subchapter, the Department of Human Services, in its sole discretion, may place a designated employee from the department to act as monitor in the facility when any of the grounds for receivership exists in a facility.
   2. The monitor shall observe operation of the facility, assist the facility by advising it on how to comply with the state and federal rules and regulations, and report periodically to the department on the operation of the facility.
   3. A monitor shall remain in a facility not to exceed sixty (60) days.
2. At the end of the monitoring period, if the department determines that insufficient progress has been made by the facility for elimination of the grounds for appointment of a receivership, the department may proceed for appointment of a receivership upon the grounds which existed at the time of placement of the monitor in the facility.
3. The department may promulgate any rules as necessary to implement this section.

History. Acts 1988 (4th Ex. Sess.), No. 3, § 1; 1988 (4th Ex. Sess.), No. 13, § 1; 2019, No. 315, §§ 1890, 1891.

Amendments. The 2019 amendment inserted “rules and” in (a)(2); and deleted “and regulations” following “rules” in (c).

20-10-916. Long-Term Care Facility Receivership Fund Account.

1. There is established on the books of the Treasurer of State, the Auditor of State, and the Chief Fiscal Officer of the State a fund account to be known as the “Long-Term Care Facility Receivership Fund Account” of the Department of Human Services Fund. The Long-Term Care Facility Receivership Fund Account shall consist of general revenues and such other funds as may be provided by law.
2. The Long-Term Care Facility Receivership Fund Account established in this section shall be administered and disbursed under the direction of the Secretary of the Department of Human Services for the purpose of paying the expenses of receivers appointed under this subchapter.
3. No money shall be expended from the Long-Term Care Facility Receivership Fund Account for any purpose except when the funds generated by a long-term care facility in this state are found to be insufficient by a court of law to pay the reasonable expenses of a receiver after all other operating expenses of the facility have been paid from the facility's revenue.
4. Any balance remaining in the Long-Term Care Facility Receivership Fund Account at the close of each fiscal year shall be retained in the Long-Term Care Facility Receivership Fund Account to be available for the same purposes.
5. Beginning July 1, 1991, and each July 1 of an odd-numbered year thereafter, the Treasurer of State shall transfer from the General Revenue Fund Account of the State Apportionment Fund to the Long-Term Care Facility Receivership Fund Account an amount sufficient to maintain a fund balance of one hundred thousand dollars ($100,000).

History. Acts 1988 (4th Ex. Sess.), No. 3, § 1; 1988 (4th Ex. Sess.), No. 13, § 1; 2019, No. 910, § 5185.

Amendments. The 2019 amendment substituted “Secretary of the Department of Human Services” for “Director of the Department of Human Services” in (b).

Subchapter 10 — Omnibus Long-Term Care Reform Act of 1988

A.C.R.C. Notes. This subchapter may be affected by § 20-10-1201 et seq.

Effective Dates. Acts 1988 (4th Ex. Sess.), No. 17, § 6: July 15, 1988. Emergency clause provided: “It is hereby found and determined by the General Assembly that the state lacks procedures to adequately protect the infirmed and frail elderly who reside in long-term care facilities within this state; That this act should go into effect immediately upon passage to shorten the amount of time required for necessary rules and regulations to be promulgated for implementation of this act and to provide at the earliest possible date some assurance to the residents of long-term care facilities that a high quality of life and the protection of their welfare and health is necessary and important to the entire citizenry of the State of Arkansas. Therefore, an emergency is hereby declared to exist and this act being necessary for the preservation of the public peace, health and safety shall be in full force and effect from and after its passage and approval.”

Acts 2019, No. 910, § 6346(b): July 1, 2019. Emergency clause provided: “It is found and determined by the General Assembly of the State of Arkansas that this act revises the duties of certain state entities; that this act establishes new departments of the state; that these revisions impact the expenses and operations of state government; and that the sections of this act other than the two uncodified sections of this act preceding the emergency clause titled ‘Funding and classification of cabinet-level department secretaries’ and ‘Transformation and Efficiencies Act transition team’ should become effective at the beginning of the fiscal year to allow for implementation of the new provisions at the beginning of the fiscal year. Therefore, an emergency is declared to exist, and Sections 1 through 6343 of this act being necessary for the preservation of the public peace, health, and safety shall become effective on July 1, 2019”.

20-10-1001. Title.

This subchapter may be known as the “Omnibus Long-Term Care Reform Act of 1988”.

History. Acts 1988 (4th Ex. Sess.), No. 17, § 1.

20-10-1002. Intent.

It is the intent of the General Assembly to provide protection for those citizens residing in long-term care facilities to assure the residents the highest quality of life while protecting their health and welfare.

History. Acts 1988 (4th Ex. Sess.), No. 17, § 1.

20-10-1003. Residents' rights.

1. A long-term care facility shall protect and promote the rights, benefits, or privileges guaranteed by law, the United States Constitution, and the Arkansas Constitution for all residents.
2. The Office of Long-Term Care shall promulgate through rules a residents' bill of rights which shall include provisions addressing each of the following as a minimum statement of residents' rights. The office may place restrictions or limitations on any right listed in this subsection when that is necessary to protect the health, welfare, or safety of the resident or other residents:
   1. The right to exercise all constitutional and legal rights;
   2. The right to a safe and clean environment;
   3. The right to dignity and respect;
   4. The right to nursing and medical care;
   5. The right to personal cleanliness;
   6. The right to choose at their own expense a personal physician and pharmacist;
   7. The right to have knowledge and input into medical treatment, records, and plan of care;
   8. The right to refuse experimental treatment;
   9. The right to confidentiality of medical records;
   10. 1. The right to be free from physical or mental abuse, corporal punishment, involuntary seclusion, and any physical or chemical restraints imposed for purposes of discipline or convenience and not required to treat the resident's medical symptoms.
       2. Restraints may be imposed only to ensure the physical safety of the resident or of other residents and only upon the written order of a physician that specifies the duration and circumstances under which the restraints are to be used, except for emergency conditions until such an order could reasonably be obtained;
   11. The right to exercise civil liberties, including the right to vote;
   12. The right to the free exercise of religion, including the right to rely on spiritual means for treatment;
   13. The right to privacy, including the right to refuse being photographed by persons other than those licensed under the Arkansas Medical Practices Act, § 17-95-201 et seq., § 17-95-301 et seq., and § 17-95-401 et seq.;
   14. The right to personal clothing and belongings;
   15. The right to personal financial information; and
   16. The right to direct whether to receive nutrition or hydration.
3. The office shall prescribe a procedure to be followed by all long-term care facilities for prompt reporting of violations of residents' rights and resolution of grievances.
4. The long-term care facility shall furnish a copy of the residents' bill of rights to each resident or resident's representative at the time of admission and to each employee of the facility. A written acknowledgment of receipt shall be included by the facility in the resident's file and personnel file of each employee.
5. 1. Failure to comply with the provisions of this section or verified violations of residents' rights shall be considered a Class B violation under § 20-10-205 for which civil penalties set forth in § 20-10-206 may be imposed.
   2. Any appeal shall be under the procedure set forth in § 20-10-208.
6. A second or subsequent offense, for purposes of determining a penalty amount, means a violation of the same right previously violated although it need not have been committed by the same employee of the facility or against the same resident.
7. The office shall prescribe through rules a synopsis of the residents' bill of rights which shall be posted at all times in a conspicuous location accessible to residents and the public in the facility.

History. Acts 1988 (4th Ex. Sess.), No. 17, § 1; 1989, No. 33, § 1; 2003, No. 1322, § 1; 2019, No. 315, §§ 1892, 1893.

A.C.R.C. Notes. Acts 2003, No. 1322, § 6, provided:

“Legislative purpose.

“(a)(1) The General Assembly recognizes that residents of long-term care facilities are among the most vulnerable of the state's citizens.

“(2) Further, the disproportionate number of these residents who are Medicaid eligible, and who have little or no close family involvement in their lives, heightens their vulnerability.

“(b) It is the intent of the General Assembly that, to ensure proper care and treatment of these individuals, particularly at end-of-life, the circumstances and conditions under which the withholding of nutrition, hydration, or both, may occur, be clarified.”

Amendments. The 2019 amendment deleted “and regulations” following “rules” in the introductory language of (b) and in (g).

20-10-1004. Prohibiting new admissions — Hearings and appeals.

1. The Director of the Office of Long-Term Care may prohibit new admissions to a long-term care facility not in compliance due to a Class A violation until the Office of Long-Term Care determines the facility is in substantial compliance.
2. If the director determines to prohibit admissions to a facility, he or she shall notify the administrator of the facility in writing, by certified mail or other means which gives actual notice, that the facility is prohibited from admitting any new residents due to a Class A violation and that the prohibition shall continue until the office makes a determination that the facility has corrected the deficiency and is in substantial compliance.
3. 1. The facility may request an immediate hearing by written request to the Secretary of the Department of Human Services.
   2. The Department of Human Services shall provide a fair and impartial hearing officer within ten (10) days of receipt of the request.
   3. Unless in conflict with this subsection, the procedure for hearings and appeals set forth in § 20-10-208 shall be followed.

History. Acts 1988 (4th Ex. Sess.), No. 17, § 1; 2019, No. 910, § 5186.

Amendments. The 2019 amendment substituted “Secretary of the Department of Human Services” for “Director of the Department of Human Services” in (c)(1).

20-10-1005. Procedure for transfer or discharge of residents — Violations.

1. The Office of Long-Term Care shall prescribe through rule the procedure for transfer or discharge of residents to be followed by long-term care facilities. The procedure shall include:
   1. Provisions for a written notice to be furnished to the resident, sponsor, and other appropriate parties thirty (30) days before any involuntary transfer or discharge and for rules setting forth the following circumstances for which the written notice need not be furnished:
      1. The transfer or discharge is necessary to meet the resident's welfare, and the resident's welfare cannot be met in the facility;
      2. The transfer or discharge is appropriate because the resident's health has improved sufficiently so that the resident no longer needs the services provided by the facility;
      3. The safety of individuals in the facility is endangered;
      4. The health of individuals in the facility would otherwise be endangered;
      5. The resident has failed, after reasonable and appropriate notice, to pay or to have paid under state-administered programs on the resident's behalf an allowable charge imposed by the facility for an item or service requested by the resident and for which a charge may be imposed consistent with federal and state laws, rules, and regulations; or
      6. The facility ceases to operate;
   2. 1. An appeals process for residents objecting to an involuntary transfer or discharge which places the burden of proof for justification of the transfer or discharge on the facility.
      2. The appeals process for objections to transfer or discharge shall include provisions for the resident or sponsor, within seven (7) days upon receipt of the written notice of transfer or discharge, to file a written objection to the transfer.
      3. Unless otherwise agreed to by the parties:
         1. A hearing shall be scheduled within fourteen (14) days following the filing of the objection; and
         2. A final determination shall be rendered within seven (7) days following the hearing; and
   3. The contents of the written notice, including a statement in clear and concise language of the appeal process to be followed by the resident and the time periods in which:
      1. The resident must request an appeal;
      2. The appeal must be heard; and
      3. The earliest date a transfer would be allowed if the decision is against the resident.
2. A request for a hearing shall stay a transfer pending a final determination.
3. If the facility prevails and the final determination is not rendered within seven (7) days of the conclusion of the hearing, the Department of Human Services shall bear the cost of the resident's continued stay in the long-term care facility until such time as the decision is rendered.
4. The facility shall provide preparation and orientation to residents to ensure a safe and orderly transfer or discharge.
5. Failure to comply with the transfer or discharge procedures as prescribed by the office shall be considered a Class B violation under § 20-10-205 for which civil penalties set forth in § 20-10-206 may be imposed.