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Arkansas Senate Bill SB236

Arkansas 2023 Regular Session

Arkansas Senate Bill SB236 Compare Versions

Only one version of the bill is available at this time.
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11 Stricken language would be deleted from and underlined language would be added to present law.
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44 State of Arkansas 1
55 94th General Assembly A Bill 2
66 Regular Session, 2023 SENATE BILL 236 3
77 4
88 By: Senator Hester 5
99 6
1010 For An Act To Be Entitled 7
1111 AN ACT TO ESTABLISH LICENSURE FOR PRESCR IBED 8
1212 PEDIATRIC EXTENDED C ARE CENTERS BY THE D EPARTMENT OF 9
1313 HEALTH; TO REQUIRE T HE ARKANSAS MEDICAID PROGRAM TO 10
1414 REIMBURSE PRESCRIBED PEDIATRIC EXTENDED C ARE CENTERS; 11
1515 AND FOR OTHER PURPOS ES. 12
1616 13
1717 14
1818 Subtitle 15
1919 TO ESTABLISH LICENSURE FOR PRESCRIBED 16
2020 PEDIATRIC EXTENDED CARE CENTERS BY THE 17
2121 DEPARTMENT OF HEALTH; AND TO REQUIRE THE 18
2222 ARKANSAS MEDICAID PROGRAM TO REIMBURSE 19
2323 PRESCRIBED PEDIATRIC EXTENDED CARE 20
2424 CENTERS. 21
2525 22
2626 23
2727 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF ARKANSAS: 24
2828 25
2929 SECTION 1. Arkansas Code Title 20, Chapter 9, is amended to add an 26
3030 additional subchapter to read as follows: 27
3131 Subchapter 16 — Prescribed Pediatric Extended Care Centers 28
3232 29
3333 20-9-1601. Definitions. 30
3434 As used in this subchapter: 31
3535 (1) "Basic nonresidential services" includes without limitation 32
3636 the development, implementation, and monitoring of a comprehensive protocol 33
3737 of care, developed in conjunction with a parent or guardian, which specifies 34
3838 the medical, nursing, psychosocial, and developmental therapies required by 35
3939 the medically dependent or technologically dependent child served as well as 36 SB236
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4444 the caregiver training needs of the child's legal guardian; 1
4545 (2) "Controlling person" means a person who has the ability, 2
4646 acting alone or in concert with others, to directly or indirectly influence, 3
4747 direct, or cause the direction of the management of, expenditure of money 4
4848 for, or policies of a prescribed pediatric extended care center, including 5
4949 without limitation: 6
5050 (A) A management company, landlord, or other busi ness 7
5151 entity that operates or contracts with another person for the operation of a 8
5252 prescribed pediatric extended care center; 9
5353 (B) Any person who controls a management company or other 10
5454 business entity that operates a prescribed pediatric extended care ce nter or 11
5555 that contracts with another person for the operation of a prescribed 12
5656 pediatric extended care center; or 13
5757 (C) Any other person who is formally named as an owner, 14
5858 manager, director, officer, provider, consultant, or employee of the 15
5959 prescribed pediatric extended care center regardless of a personal, familial, 16
6060 or other relationship with the owner, manager, landlord, tenant, or provider 17
6161 of a prescribed pediatric extended care center; 18
6262 (3)(A) "Medically dependent or technologically dependent child" 19
6363 means a child who because of a medical condition requires continuous 20
6464 therapeutic interventions or skilled nursing supervision prescribed by a 21
6565 licensed physician and administered by, or under the direct supervision of, a 22
6666 licensed registered nurse with three (3) to five (5) years of experience. 23
6767 (B) "Medically dependent or technologically dependent 24
6868 child" includes without limitation a child who has or is: 25
6969 (i) Born addicted to drugs; 26
7070 (ii) Burns; 27
7171 (iii) Congenital disorders; 28
7272 (iv) End stage diseases; 29
7373 (v) Failure to thrive; 30
7474 (vi) Feeding disorders; 31
7575 (vii) Gastrointestinal or enteral feedings; 32
7676 (viii) Genetic disorders; 33
7777 (ix) Metabolic and endocrine disorders including 34
7878 diabetes with technology assistance; 35
7979 (x) Oncological and hematological disorders; 36 SB236
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8484 (xi) Orthopedic conditions including amputations and 1
8585 surgery; 2
8686 (xii) Post operation care; 3
8787 (xiii) Post traumatic injury; or 4
8888 (xiv) Prematurity and respiratory disorders; 5
8989 (4) "Minor" means an individual who is twenty-one (21) years of 6
9090 age or younger; 7
9191 (5) "Prescribed pediatric extended care center" means any 8
9292 building or other facility, whether operated for profit or not, which 9
9393 undertakes through its ownership or management to provide basic 10
9494 nonresidential services to three (3) or more medically dependent or 11
9595 technologically dependent children who are not related to the owner or 12
9696 operator by blood, marriage, or adoption and who require basic nonresidential 13
9797 services; and 14
9898 (6) "Supportive services or contrac ted services" means speech 15
9999 therapy, occupational therapy, physical therapy, social work, developmental, 16
100100 child life, psychological services, and other services to support the child. 17
101101 18
102102 20-9-1602. License required — Exemption. 19
103103 (a) A person or entity shall not own or operate a prescribed pediatric 20
104104 extended care center in this state unless the person or entity holds a 21
105105 license under this subchapter. 22
106106 (b)(1) A separate license is required for a prescribed pediatric 23
107107 extended care center maintained on separate p remises, regardless of whether 24
108108 the prescribed pediatric extended care center is operated under the same 25
109109 management. 26
110110 (2) A separate license is not required for separate buildings on 27
111111 the same grounds. 28
112112 (c) A facility that is operated by the United States Government or any 29
113113 agency of the United States Government is exempt from licensure under this 30
114114 subchapter. 31
115115 32
116116 20-9-1603. Application — Issuance of license. 33
117117 (a) An applicant for a prescribed pediatric extended care center 34
118118 license shall submit to the Depart ment of Health: 35
119119 (1) An application on the form prescribed by the department; 36 SB236
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124124 (2) A letter of credit as prescribed by the department to 1
125125 demonstrate the applicant’s financial viability; and 2
126126 (3) Application fees as determined by the department. 3
127127 (b) The application under subsection (a) of this section shall 4
128128 contain: 5
129129 (1) The location of the premises of the prescribed pediatric 6
130130 extended care center for which the license is sought; 7
131131 (2) Documentation, signed by the appropriate local government 8
132132 official, stating that the location and use of the premises meet local zoning 9
133133 requirements; 10
134134 (3) The name, address, and Social Security number of and 11
135135 criminal background check information for: 12
136136 (A) The applicant; 13
137137 (B) The administrator responsible for daily operations of 14
138138 the prescribed pediatric extended care center; 15
139139 (C) The financial officer responsible for financial 16
140140 operations of the prescribed pediatric extended care center; and 17
141141 (D) Each controlling person; 18
142142 (4) The name, address, and feder al employer identification 19
143143 number or taxpayer identification number of the applicant and of each 20
144144 controlling person, if the applicant or controlling person is not an 21
145145 individual; 22
146146 (5) The business name of the prescribed pediatric extended care 23
147147 center; 24
148148 (6) The maximum patient capacity requested for the prescribed 25
149149 pediatric extended care center; 26
150150 (7) A sworn affidavit that the applicant has complied with this 27
151151 subchapter and rules adopted under this subchapter; and 28
152152 (8) Documentation that the applican t has at least one (1) person 29
153153 on staff with a degree in accounting or finance from an accredited 30
154154 institution of higher education and has at least five (5) years' experience. 31
155155 (c)(1) The department shall issue a license to a prescribed pediatric 32
156156 extended care center under this subchapter if the department determines that 33
157157 the applicant and the prescribed pediatric extended care center meet the 34
158158 requirements of this subchapter and comply with the rules and standards 35
159159 adopted under this subchapter. 36 SB236
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164164 (2) The license shall include: 1
165165 (A) The license holder’s name; 2
166166 (B) The location of the premises of the prescribed 3
167167 pediatric extended care center; and 4
168168 (C) A statement indicating that the prescribed pediatric 5
169169 extended care center provides services to minor s for twelve (12) hours or 6
170170 less in a twenty-four-hour period and does not provide twenty -four-hour care. 7
171171 (d) A county-operated or municipally operated prescribed pediatric 8
172172 extended care center applying for licensure under this subchapter is exempt 9
173173 from the payment of license fees. 10
174174 (e) A license under this subchapter is issued to the license holder 11
175175 named on the license at the location of the premises listed on the license 12
176176 and is not transferable or assignable. 13
177177 14
178178 20-9-1604. License term — Renewal. 15
179179 (a) A license issued under this subchapter expires on the second 16
180180 anniversary of the date of issuance. 17
181181 (b) A person applying to renew a prescribed pediatric extended care 18
182182 center license shall: 19
183183 (1) Submit a renewal application to the Department of Health on 20
184184 the form prescribed by the department at least sixty (60) days but not more 21
185185 than one hundred twenty (120) days before expiration of the license; 22
186186 (2) Submit the renewal fee in the amount required by the 23
187187 department; and 24
188188 (3) Comply with any other requi rements specified by rule. 25
189189 (c)(1) The department shall assess a fifty dollar ($50) per day late 26
190190 fee to a license holder who submits a renewal application after the date 27
191191 required by subdivision (b)(1) of this section. 28
192192 (2) However, the total amount of a late fee shall not exceed the 29
193193 lesser of fifty percent (50%) of the license renewal fee or five hundred 30
194194 dollars ($500). 31
195195 (d) At least one hundred twenty (120) days before expiration of a 32
196196 prescribed pediatric extended care center license, the department sh all 33
197197 notify the owner or operator of the prescribed pediatric extended care center 34
198198 of the license expiration. 35
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204204 20-9-1605. Denial, suspension, or revocation of licensure — 1
205205 Disciplinary action grounds. 2
206206 (a) The Department of Health may deny, revoke, and su spend a license 3
207207 and impose an administrative fine for a violation of this subchapter or 4
208208 applicable rules. 5
209209 (b) Any of the following actions by a prescribed pediatric extended 6
210210 care center or a controlling person or employee of a prescribed pediatric 7
211211 extended care center is grounds for disciplinary and administrative action by 8
212212 the department: 9
213213 (1) An intentional or negligent act materially affecting the 10
214214 health or safety of children in the prescribed pediatric extended care 11
215215 center; 12
216216 (2) A violation of thi s subchapter or applicable rules; or 13
217217 (3) Multiple and repeated violations of this subchapter or of 14
218218 minimum standards or rules adopted under this subchapter. 15
219219 16
220220 20-9-1606. Administrative fines — Corrective action plan. 17
221221 (a) If the Department of Health determines that a prescribed pediatric 18
222222 extended care center is not in compliance with this subchapter or applicable 19
223223 rules, the department may request that the prescribed pediatric extended care 20
224224 center submit a corrective action plan that demonstrates a goo d-faith effort 21
225225 to remedy each violation by a specific date, subject to the approval of the 22
226226 department. 23
227227 (b)(1) The department may fine a prescribed pediatric extended care 24
228228 center or employee found in violation of this subchapter or applicable rules, 25
229229 in an amount not to exceed five hundred dollars ($500) for each violation. 26
230230 (2) The fine described in subdivision (b)(1) of this section 27
231231 shall not exceed five thousand dollars ($5,000) in the aggregate. 28
232232 (c) The failure to correct a violation by the date set by the 29
233233 department, or the failure to comply with an approved corrective action plan, 30
234234 is a separate violation for each day such failure continues, unless the 31
235235 department approves an extension to a specific date. 32
236236 (d) In determining if a fine is to be impos ed and in fixing the amount 33
237237 of any fine, the department shall consider the following factors: 34
238238 (1) The gravity of the violation, including the probability that 35
239239 death or serious physical or emotional harm to a child will result or has 36 SB236
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244244 resulted, the severi ty of the actual or potential harm, and the extent to 1
245245 which this subchapter or rules were violated; 2
246246 (2) Actions taken by the owner, operator, or controlling person 3
247247 to correct violations; 4
248248 (3) Any previous violations; and 5
249249 (4) The financial benefit t o the prescribed pediatric extended 6
250250 care center of committing or continuing the violation. 7
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252252 20-9-1607. Closing of a prescribed pediatric extended care center. 9
253253 Whenever a prescribed pediatric extended care center voluntarily 10
254254 discontinues operation, the p rescribed pediatric extended care center shall, 11
255255 at least thirty (30) days before the discontinuance of operation, inform each 12
256256 child's legal guardian of the fact and the proposed time of such 13
257257 discontinuance. 14
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259259 20-9-1608. Construction and renovation. 16
260260 The requirements for the construction or renovation of a prescribed 17
261261 pediatric extended care center shall comply with: 18
262262 (1) The provisions of law, which pertain to building 19
263263 construction standards, including plumbing, electrical code, glass, 20
264264 manufactured buildings, and accessibility for individuals with physical 21
265265 disabilities; 22
266266 (2) The minimum standards for physical facilities in the child 23
267267 care facilities; and 24
268268 (3) The standards or rules adopted pursuant to this subchapter. 25
269269 26
270270 20-9-1609. License display — Maintenance of records. 27
271271 A prescribed pediatric extended care center licensed under this 28
272272 subchapter shall: 29
273273 (1) Display the license issued under this subchapter in a 30
274274 conspicuous location readily visible to a person entering the prescribed 31
275275 pediatric extended care center; and 32
276276 (2) Maintain at the center the medical and other records 33
277277 required by this subchapter and by rules adopted under this subchapter. 34
278278 35
279279 20-9-1610. Admission criteria for minors. 36 SB236
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284284 (a) A prescribed pediatric extended care center shall no t admit a 1
285285 minor unless: 2
286286 (1) The client is a medically dependent or technologically 3
287287 dependent minor; 4
288288 (2) The minor’s prescribing physician issues a prescription 5
289289 ordering care at a prescribed pediatric extended care center; 6
290290 (3) The minor’s parent or legal guardian consents to the minor’s 7
291291 admission to the prescribed pediatric extended care center; and 8
292292 (4) The admission is voluntary based on the parent’s or legal 9
293293 guardian’s preference in both managed care and nonmanaged care service 10
294294 delivery systems. 11
295295 (b) An admission authorized under this section does not supplant the 12
296296 right to a Medicaid private duty nursing benefit when medically necessary. 13
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298298 20-9-1611. Complaints. 15
299299 (a) A person may file a complaint with the Department of Health 16
300300 against a prescribed pediatric extended care center licensed or required to 17
301301 be licensed under this subchapter. 18
302302 (b) The department shall investigate the complaint in accordance with 19
303303 the Arkansas Administrative Procedure Act, § 25 -15-201 et seq. 20
304304 21
305305 20-9-1612. Penalty. 22
306306 (a) Any person who violates this subchapter is upon conviction guilty 23
307307 of an unclassified misdemeanor subject to a fine of ten thousand dollars 24
308308 ($10,000). 25
309309 (b) Each day of continuing violation is a separate offense. 26
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311311 20-9-1613. Rules and standards. 28
312312 (a) The Department of Health shall adopt and publish rules to 29
313313 implement this subchapter, which shall include reasonable and fair standards. 30
314314 (b) Any conflict between the standards set by the department and 31
315315 standards that may be set forth in local, count y, or city ordinances shall be 32
316316 resolved in favor of those having statewide effect. 33
317317 (c) The department shall include standards that relate to: 34
318318 (1) The assurance that services provided by a prescribed 35
319319 pediatric extended care center are family centered a nd provide individualized 36 SB236
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324324 medical, developmental, and family training services; 1
325325 (2) The maintenance of prescribed pediatric extended care 2
326326 centers, based upon the size of the structure and number of children, 3
327327 relating to plumbing, heating, lighting, vent ilation, and other building 4
328328 conditions, including adequate space, which will ensure the health, safety, 5
329329 comfort, and protection from fire of the children served; 6
330330 (3) The appropriate provisions of the most recent edition of the 7
331331 National Fire Protection A ssociation 101 Life Safety Code shall be applied; 8
332332 (4) The number and qualifications of all personnel who have 9
333333 responsibility for the care of the children served; 10
334334 (5) All sanitary conditions within the prescribed pediatric 11
335335 extended care center and its surroundings, including water supply, sewage 12
336336 disposal, food handling and general hygiene, and maintenance; 13
337337 (6) Programs and basic services promoting and maintaining the 14
338338 health and development of the children served and meeting the training needs 15
339339 of the children's parents or legal guardians; 16
340340 (7) Supportive, contracted, other operational and transportation 17
341341 services; and 18
342342 (8) Maintenance of appropriate medical records, data, and 19
343343 information relative to the children and programs. 20
344344 (d) The department s hall adopt rules to ensure that a: 21
345345 (1) Child does not attend a prescribed pediatric extended care 22
346346 center for more than twelve (12) hours within a twenty -four-hour period; and 23
347347 (2) Prescribed pediatric extended care center does not provide 24
348348 services other than those provided to medically or technologically dependent 25
349349 children. 26
350350 27
351351 SECTION 2. Arkansas Code Title 20, Chapter 77, Subchapter 1, is 28
352352 amended to add an additional section to read as follows: 29
353353 20-77-148. Prescribed pediatric extended care center. 30
354354 (a) The Arkansas Medicaid Program shall: 31
355355 (1) Provide reimbursement for services provided through a 32
356356 prescribed pediatric extended care center licensed in this state; and 33
357357 (2) Develop a new Medicaid provider type for a prescribed 34
358358 pediatric extended car e center. 35
359359 (b) The Department of Human Services shall apply for any federal 36 SB236
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365365 implement this section. 2
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