Stricken language would be deleted from and underlined language would be added to present law.
Act 636 of the Regular Session
*JMB064* 03-31-2025 13:35:19 JMB064
State of Arkansas As Engrossed: H3/5/25 H3/31/25 1
95th General Assembly A Bill 2
Regular Session, 2025 HOUSE BILL 1653 3
4
By: Representatives Cavenaugh, Wooldridge 5
By: Senator Irvin 6
7
For An Act To Be Entitled 8
AN ACT TO MOVE LICENSING AND REGULATION OF 9
PSYCHIATRIC RESIDENTIAL TREATMENT FACILITIES FROM THE 10
CHILD WELFARE AGENCY REVIEW BOARD TO THE DEPARTMENT 11
OF HUMAN SERVICES; TO SET STANDARDS FOR THE LICENSING 12
AND REGULATION OF PSYCHIATRIC RESIDENTIAL TREATMENT 13
FACILITIES; TO DECLARE AN EMERGENCY; AND FOR OTHER 14
PURPOSES. 15
16
17
Subtitle 18
TO SET STANDARDS FOR LICENSING AND 19
REGULATION OF PSYCHIATRIC RESIDENTIAL 20
TREATMENT FACILITIES; AND TO DECLARE AN 21
EMERGENCY. 22
23
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF ARKANSAS: 24
25
SECTION 1. Arkansas Code § 20 -8-107(c) and (d), concerning the 26
expansion of facilities or services permitted by Health Services Permit 27
Agency, are amended to read as follows: 28
(c) In no event shall the requirements of this subchapter apply to any 29
facility licensed or approved as of March 1, 2003, by the Child Welfare 30
Agency Review Board pursuant to the Child Welfare Agency Licensing Act, § 9 -31
28-401 et seq., and as specifically exempted by § 9 -28-407(a)(3). 32
(d) Beginning July 1, 2005, the Health Services Permit Agency may not 33
accept applications or requests for permits of approval to add new beds or to 34
expand existing bed capacity of residential care facilities. 35
(d)(1) The Health Services Permit Agency shall recognize an exception 36 As Engrossed: H3/5/25 H3/31/25 HB1653
2 03-31-2025 13:35:19 JMB064
to the moratorium regarding bed capacity and beds in a psychiatric 1
residential treatment facility. 2
(2) The Health Services Permit Agency shall add to the permitted 3
bed capacity for psychiatric residential treatment facilities: 4
(A) Beds that are not currently permitted by the Health 5
Services Permit Agency but are licensed by the Child Welfare Agency Review 6
Board for the purpose of operating as a psychiatric residential treatment 7
facility before the effective date of this subsection; and 8
(B) Beds that are fully constructed and could be used for 9
the purpose of operating a psychiatric residential treatment facility as of 10
January 1, 2025. 11
(3) The total amount of additional beds authorized under this 12
subsection shall not exceed nine hundred (900) beds for the purpose of 13
operating as a psychiatric residential treatment facility. 14
(4) The Health Services Permit Agency shall require prior 15
approval under § 20-8-109 for any new construction of a psychiatric 16
residential treatment facility and for any renovation project that exceeds 17
two hundred fifty thousand dollars ($250,000) for an existing psychiatric 18
residential treatment facility. 19
(5) Any increase or decrease in the total number of authorized 20
beds under this section shall be reviewed and approved by the Legislative 21
Council before receiving a permit from the Health Services Permit Agency or a 22
license from the Office of Long -Term Care. 23
(6) For the purposes of this section, beds used for both in -24
state and out-of-state clients shall be counted in capacity for the purpose 25
of obtaining a permit from the Health Services Permit Agency. 26
27
SECTION 2. Arkansas Code § 20 -10-101(1), concerning the definition of 28
"administrative remedy" relating to long -term care facilities and services, 29
is amended to read as follows: 30
(1) “Administrative remedy” means temporary management, denial 31
of payment for all new admissions, transfer of residents, termination or 32
suspension of license, termination of provider agreement, directed plan of 33
correction, directed in -service training, and remedies established by 34
Arkansas law, including remedies provided in § 20 -10-1408 [repealed]; 35
36 As Engrossed: H3/5/25 H3/31/25 HB1653
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SECTION 3. Arkansas Code § 20-10-101(9)(A), concerning the definition 1
of "long-term care facility" relating to long -term care facilities and 2
services, is amended to read as follows: 3
(9)(A) “Long-term care facility” means a nursing home, 4
residential care facility, assisted living facility, psychiatric residential 5
treatment facility, post-acute head injury retraining and residential care 6
facility, or any other facility which provides long -term medical or personal 7
care. 8
9
SECTION 4. Arkansas Code § 20 -10-101, concerning definitions relating 10
to long-term care facilities and services, is amended to add an additional 11
subdivision to read as follows: 12
(16)(A) "Psychiatric residential treatment facility" means a 13
standalone, nonhospital facility with a provider agreement with the Arkansas 14
Medicaid Program to provide inpatient services benefits to individuals who 15
are under twenty-one (21) years of age and that: 16
(i) Is accredited by The Joint Commission or any 17
other accrediting organization with comparable standards recognized by this 18
state; 19
(ii) Attests to meeting the conditions of 20
participation found at 42 C.F.R. Part 483, Subpart G, as existing on January 21
1, 2025; and 22
(iii) Attests that all of the residents in the 23
facility meet the certification of need for services requirements as 24
identified under 42 C.F.R. Part 441, Subpart D, as existing on January 1, 25
2025. 26
(B)(i) A survey and certification review of a psychiatric 27
residential treatment facility by the department shall apply to all residents 28
being served by the entity regardless of residency or payment source. 29
(ii) All residents of a psychiatric residential 30
treatment facility shall require intensive inpatient services for psychiatric 31
conditions under the direction of a physician and the services provided shall 32
be reasonably expected to improve the resident’s condition or prevent further 33
regression until the services are no longer needed. 34
35
SECTION 5. Arkansas Code § 20 -10-110(a)(2), concerning the definition 36 As Engrossed: H3/5/25 H3/31/25 HB1653
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of "long-term care facility" relating to the protection of residents' 1
personal funds, is amended to read as follows: 2
(2) “Long-term care facility” means a nursing home, residential 3
care facility, post-acute head injury retraining and residential care 4
facility, assisted living facility, psychiatric residential treatment 5
facility, or any other facility that provides long -term medical or personal 6
care; 7
8
SECTION 6. Arkansas Code § 20 -10-402 is amended to read as follows: 9
20-10-402. License required. 10
(a) It shall be unlawful for any person to act or serve in the 11
capacity of nursing home long-term care facility administrator in this state 12
unless the person has been licensed to do so as authorized in this 13
subchapter. 14
(b) A person who serves as an administrator of a long -term care 15
facility conducted exclusively for persons who rely upon treatment by 16
spiritual means through prayer in accordance with the creed or tenets of a 17
church or religious denomination shall be exempt from subsection (a) of this 18
section and § 20-10-101(1)-(6), § 20-10-203(b), § 20-10-212, §§ 20-10-301 — 19
20-10-303 [repealed], § 20 -10-403, § 20-10-405(b) § 20-10-405(a)(2), § 20-10-20
406, and § 20-10-407. 21
22
SECTION 7. Arkansas Code § 20 -10-404(a), concerning the application 23
and fees for licensure as a long -term care facility administrator, is amended 24
to read as follows: 25
(a) Any person desiring to be licensed as a nursing home long-term 26
care facility administrator shall make application to the Office of Long -Term 27
Care on forms prescribed by the office and shall furnish such information 28
with the application as shall be required by the office. 29
30
SECTION 8. Arkansas Code § 20 -10-405 is amended to read as follows: 31
20-10-405. Renewal. 32
(a)(1) Every active nursing home administrator's license shall be 33
renewed on or before July 1 of each year by paying a fee of one hundred 34
dollars ($100) to the Office of Long -Term Care and by furnishing written 35
documentation that the licensee has attended and accumulated a specific 36 As Engrossed: H3/5/25 H3/31/25 HB1653
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number of continuing education clock hours as established by the office. 1
(b)(2) The fee for those nursing home administrators not actively 2
employed by a nursing home facility as an administrator shall be fifty 3
dollars ($50.00), payable on or before July 1 of each year. 4
(c)(3) If the annual licensure fee in full along with the renewal 5
application and satisfactory documentation of compliance with continuing 6
education requirements is not postmarked or received by the office on or 7
before July 1, the licensee shall be ineligible to perform the duties of 8
nursing home administrator, and the license shall be deemed suspended 9
effective July 2. 10
(d)(4) No request for renewal postmarked or received by the office 11
after July 1 shall be considered unless, in addition to other requirements 12
imposed by law or rule, the licensee tenders a late charge in the amount of 13
fifty dollars ($50.00). 14
(e)(5) Any nursing home administrator license not renewed on or before 15
September 1 shall expire effective September 2. 16
(b) An administrator for a long -term care facility other than a 17
nursing home shall be required to renew his or her license as follows: 18
(1) Every active administrator license shall be renewed on or 19
before January 1 of each year by submitting a renewal application to the 20
Department of Human Services and by furnishing written documentation that the 21
licensee has attended and accumulated a specific number of continuing 22
education clock hours as established by the department; 23
(2) If the renewal application and satisfactory documentation of 24
compliance with continuing education requirements is not postmarked or 25
received by the department on or before January 1, the licensee shall be 26
ineligible to perform the duties of long -term care facility administrator, 27
and the license shall be deemed suspended effective January 2; 28
(3) A request for renewal postmarked or received by the 29
department after January 1 shall not be considered unless the licensee 30
complies with all of the requirements imposed by law or rule; and 31
(4) Any long-term care facility administrator license not 32
renewed on or before March 1 shall expire effective March 2. 33
34
SECTION 9. Arkansas Code § 20 -10-407(a), concerning the denial, 35
revocation, or suspension of a long -term care facility administrator's 36 As Engrossed: H3/5/25 H3/31/25 HB1653
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license, is amended to read as follows: 1
(a) The Department of Human Services may refuse to issue or renew a 2
long-term care facility administrator's license or may revoke or suspend the 3
license of a long-term care facility administrator if the department finds 4
that the applicant or licensee does not qualify for licensure or has violated 5
§ 20-10-101(1)-(6), § 20-10-203(b), § 20-10-212, §§ 20-10-402 and 20-10-403, 6
§ 20-10-405(b) § 20-10-405(a)(2), § 20-10-406, and this section or rules of 7
the department relating to the proper administration and management of a 8
long-term care facility. 9
10
SECTION 10. Arkansas Code Title 20, Chapter 46, Subchapter 4 is 11
amended to read as follows: 12
Subchapter 4 — Psychiatric Residential Treatment Facilities 13
14
20-46-401 - 20-46-404. [Repealed.] 15
16
20-46-401. Admission of children to psychiatric residential treatment 17
facilities. 18
(a) A psychiatric residential treatment facility licensed under this 19
subchapter and holding a permit from the Health Services Permit Agency or the 20
Health Services Permit Commission shall not admit a child for psychiatric 21
residential treatment unless the child is: 22
(1) An Arkansas resident; 23
(2) A child of a parent who is an Arkansas resident; 24
(3) A child placed by or on behalf of another state’s child 25
welfare agency; 26
(4) A child for whom the facility is being paid by another 27
state's Medicaid program; 28
(5) A child of an active -duty member or veteran of the uniformed 29
services as defined in § 6 -4-302; or 30
(6) A nonresident child victim of human trafficking when the 31
regulated facility maintains responsibility for the return of the child to an 32
out-of-state custodian. 33
(b) The Department of Human Services may promulgate rules to enforce 34
this section. 35
36 As Engrossed: H3/5/25 H3/31/25 HB1653
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1
20-46-402. Licensure — Unlawful acts. 2
(a)(1) It is unlawful for any person, partnership, group, corporation, 3
association, or other entity or identifiable group of entities having a 4
coordinated ownership with controlling interest to operate or assist in the 5
operation of a psychiatric residential treatment facility that has not been 6
licensed by the Office of Long -Term Care under this subchapter. 7
(2) Before obtaining a license under this subchapter, a 8
psychiatric residential treatment facility shall obtain a permit from the 9
Health Services Permit Agency or Health Services Permit Commission to operate 10
in Arkansas. 11
(3) The bed capacity allowed by the permit issued by the Health 12
Services Permit Agency or Health Services Permit Commission includes both in -13
state and out-of-state clients. 14
(4) Any expansion of bed capacity by an existing licensee shall 15
require a license from the office and a permit from the Health Services 16
Permit Agency. 17
(5)(A) A license issued by the office under this subchapter is 18
effective unless revoked, suspended, or terminated by the office. 19
(B) In addition to any other basis provided by law or 20
rule, the Department of Human Services shall terminate the license of a 21
psychiatric residential treatment facility licensee that has not been in 22
operation for a consecutive twelve -month period. 23
(C) The department may revoke, suspend, or terminate a 24
license upon any basis provided by law or rule, including without limitation 25
the failure to be in operation or in substantial compliance for a consecutive 26
six-month period. 27
(b) It is unlawful for any person to falsify an application for 28
licensure, to knowingly circumvent the authority of this subchapter, to 29
knowingly violate the orders issued by the department, or to advertise for 30
inpatient psychiatric residential treatment when not licensed under this 31
subchapter to provide those services. 32
(c) Any violation of this section shall constitute a Class D felony. 33
34
20-46-403. Licensure posting and display. 35
If the Department of Human Services issues a license to operate a 36 As Engrossed: H3/5/25 H3/31/25 HB1653
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psychiatric residential treatment facility, the license shall be posted and 1
displayed in a conspicuous place in the facility and must state at a minimum: 2
(1) The full legal name of the person, partnership, group, 3
corporation, organization, association, or other entity or identifiable group 4
of entities having a coordinated ownership with controlling interest holding 5
the license, including the business name, if different; 6
(2) The address of the psychiatric residential treatment 7
facility; 8
(3) The effective date and expiration date of the license, if 9
applicable; 10
(4) The type of psychiatric residential treatment facility the 11
licensee is authorized to operate; 12
(5) The ages and maximum number of children that may receive 13
services from the psychiatric residential treatment facility; 14
(6) The status of the license, whether regular, provisional, or 15
probationary; and 16
(7) Any special conditions or limitations of the license. 17
18
20-46-404. Services provided by psychiatric residential treatment 19
facilities. 20
(a) A psychiatric residential treatment facility licensed under this 21
subchapter shall: 22
(1)(A) Provide a range of comprehensive services to treat the 23
psychiatric condition of residents on an inpatient basis under the direction 24
of a physician. 25
(B) The psychiatric residential treatment facility shall 26
certify that: 27
(i) Ambulatory care services available in the 28
community do not meet the treatment needs of the resident; 29
(ii) Proper treatment of the resident's psychiatric 30
condition requires services on an inpatient basis under the direction of a 31
physician; and 32
(iii) The services can reasonably be expected to 33
improve the resident’s condition or prevent further regression so that the 34
services will no longer be needed. 35
(C) The certification required in subdivision (a)(1)(B) of 36 As Engrossed: H3/5/25 H3/31/25 HB1653
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this section shall be made by an independent team that: 1
(i) Includes a physician; 2
(ii) Has competence in diagnosis and treatment of 3
mental illness, preferably in child psychiatry; and 4
(iii) Has knowledge of the resident's situation; and 5
(2) Provide services to a resident according to an individual 6
plan of care that: 7
(A) Is based on a diagnostic evaluation that includes 8
examination of the medical, psychological, social, behavioral, and 9
developmental aspects of the resident's situation and reflects the need for 10
inpatient psychiatric care; 11
(B) Is developed by a team of professionals in 12
consultation with the resident, parents, legal guardians, or other 13
individuals in whose care the resident will be released after discharge; 14
(C) Describes clear and concise treatment objectives; 15
(D) Ensures continuity of care with the resident’s family, 16
school and educational requirements, and community upon discharge; 17
(E) Determines that services being provided are or were 18
required on an inpatient basis; and 19
(F) Recommends changes in the plan of care as indicated by 20
the resident's overall adjustment as an inpatient. 21
(b) The Department of Human Services shall promulgate rules to 22
implement this subchapter, which shall include components that ensure quality 23
of care, health and safety of residents and facility staff, and compliance 24
with all educational requirements. 25
26
27
SECTION 11. Arkansas Code § 9 -28-402(8), concerning the definition of 28
"child welfare agency" within the Child Welfare Agency Licensing Act, is 29
amended to read as follows: 30
(8) “Child welfare agency” means any person, corporation, 31
partnership, voluntary association, or other entity or identifiable group of 32
entities having a coordinated ownership of controlling interest, whether 33
established for profit or otherwise, that is not excluded under this 34
subchapter and engages in any of the following activities: 35
(A) Receives a total number of six (6) or more unrelated 36 As Engrossed: H3/5/25 H3/31/25 HB1653
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minors for care on a twenty -four-hour basis for the purpose of ensuring the 1
minors receive care, training, education, custody, or supervision, whether or 2
not there are six (6) or more children cared for at any single physical 3
location; 4
(B) Places any unrelated minor for care on a twenty -four-5
hour basis with persons other than themselves; 6
(C) Plans for or assists in the placements described in 7
subdivision (8)(B) of this section; or 8
(D) Receives, places, plans, or assists in the placement 9
of a child victim of human trafficking in a home or any type of shelter or 10
facility; 11
12
SECTION 12. Arkansas Code § 9 -28-402(12), concerning the definition of 13
"exempt child welfare agency" within the Child Welfare Agency Licensing Act, 14
is amended to read as follows: 15
(12) “Exempt child welfare agency” means any person, 16
corporation, partnership, voluntary association or other entity, whether 17
established for profit or otherwise, that otherwise fits the definition of a 18
child welfare agency but that is specifically exempt from the requirement of 19
obtaining a license under this subchapter. Those agencies specifically exempt 20
from the license requirement are: 21
(A) A facility or program owned or operated by an agency 22
of the United States Government; 23
(B)(i) Any agency of the State of Arkansas that is 24
statutorily authorized to administer or supervise child welfare activities. 25
(ii) In order to maintain exempt status, the state 26
child welfare agency shall state every two (2) years in written form signed 27
by the persons in charge that their agency is in substantial compliance with 28
published state agency child welfare standards. 29
(iii) Visits to review and advise exempt state 30
agencies shall be made as deemed necessary by the Child Welfare Agency Review 31
Board to verify and maintain substantial compliance with the standards; 32
(C) A facility or program owned or operated by or under 33
contract with the Division of Correction; 34
(D) A hospital providing acute care licensed pursuant to § 35
20-9-201 et seq.; 36 As Engrossed: H3/5/25 H3/31/25 HB1653
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(E)(D) Any facility governed by the Department of Human 1
Services State Institutional System Board or its successor; 2
(F) Human development centers regulated by the Board of 3
Developmental Disabilities Services pursuant to the Location Act for 4
Community Homes for Individuals with Intellectual and Developmental 5
Disabilities, § 20-48-601 et seq.; 6
(G) Any facility licensed as a family home pursuant to the 7
Location Act for Community Homes for Individuals with Intellectual and 8
Developmental Disabilities, § 20 -48-601 et seq.; 9
(H)(E) Any boarding school as defined in this section; 10
(I)(F) Any temporary camp as defined in this section; 11
(J)(G) Any state-operated facility to house juvenile 12
delinquents or any serious offender program facility operated by a state 13
designee to house juvenile delinquents. Those facilities shall be subject to 14
program requirements modeled on nationally recognized correctional facility 15
standards that shall be developed, administered, and monitored by the 16
Division of Youth Services; and 17
(K)(H) Any child welfare agency operated solely by a 18
religious organization that elects to be exempt from licensing and that 19
complies within the conditions of the exemption for church -operated agencies 20
as set forth in this subchapter; 21
(L) The Division of Developmental Disabilities Services; 22
and 23
(M) Any intellectual or other developmental disabilities 24
services waiver provider licensed under § 20 -48-208 or the Location Act for 25
Community Homes for Individuals with Intellectual and Developmental 26
Disabilities, § 20-48-601 et seq.; 27
28
SECTION 13. Arkansas Code § 9 -28-402(18) is repealed. 29
(18) “Psychiatric residential treatment facility” means a 30
residential childcare facility in a nonhospital setting that provides a 31
structured, systematic, therapeutic program of treatment under the 32
supervision of a psychiatrist, for children who are emotionally disturbed and 33
in need of daily nursing services, psychiatrist's supervision, and 34
residential care but who are not in an acute phase of illness requiring the 35
services of an inpatient psychiatric hospital; 36 As Engrossed: H3/5/25 H3/31/25 HB1653
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1
SECTION 14. Arkansas Code § 9 -28-402(22), concerning the definition of 2
"residential childcare facility" within the Child Welfare Agency Licensing 3
Act, is amended to read as follows: 4
(22)(A) “Residential childcare facility” means any child welfare 5
agency that is not an excluded child welfare agency under this subchapter and 6
provides care, training, education, custody, or supervision on a twenty -four-7
hour basis for six (6) or more unrelated children, excluding foster homes 8
that have six (6) or more children who are all related to each other but who 9
are not related to the foster parents . 10
(B) A "residential childcare facility" does not include a 11
facility that provides inpatient psychiatric treatment, which shall not be 12
licensed as a residential childcare facility ; 13
14
SECTION 15. Arkansas Code § 9 -28-402, concerning the definitions 15
within the Child Welfare Agency Licensing Act, is amended to add an 16
additional subdivision to read as follows: 17
(32) "Excluded child welfare agency" means any person, 18
corporation, partnership, voluntary association, or other entity, whether 19
established for-profit or otherwise, that meets the definition of a child 20
welfare agency or an exempt child welfare agency but is licensed or certified 21
by the Department of Human Services or the Department of Health and is 22
enrolled in the Arkansas Medicaid Program. 23
24
SECTION 16. Arkansas Code § 9 -28-403(a), concerning the creation and 25
authority of the Child Welfare Agency Review Board, is amended to read as 26
follows: 27
(a)(1) There is created the Child Welfare Agency Review Board to serve 28
as the administrative body to carry out the provisions of this subchapter. 29
(2) The board shall have the authority to promulgate rules to 30
enforce the provisions of this subchapter. 31
(3) An excluded child welfare agency is not subject to the 32
provisions of this subchapter. 33
34
SECTION 17. Arkansas Code § 9 -28-404(a)(5), concerning the membership 35
of the Child Welfare Agency Review Board, is repealed. 36 As Engrossed: H3/5/25 H3/31/25 HB1653
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(5) One (1) representative from a licensed psychiatric 1
residential treatment facility; 2
3
SECTION 18. Arkansas Code § 9 -28-407(a)(3) and (4), concerning 4
licenses required and issued by the Child Welfare Agency Review Board, are 5
repealed. 6
(3) Any child welfare agency capacity licensed by the board as 7
of March 1, 2003, whether held by the original licensee or by a successor in 8
interest to the original licensee, is exempted from: 9
(A) Obtaining any license or permit from the Office of 10
Long-Term Care; and 11
(B)(i) Obtaining any permit from the Health Services 12
Permit Agency or the Health Services Permit Commission to operate at the 13
capacity licensed by the board as of March 1, 2003, except as required under 14
subdivision (a)(3)(B)(ii) of this section. 15
(ii)(a) If a licensee is operating at less than or 16
at the capacity licensed by the board as of March 1, 2021, the licensee shall 17
obtain a permit from the Health Services Permit Agency or the Health Services 18
Permit Commission for any increase in capacity. 19
(b) For the purposes of subdivision 20
(a)(3)(B)(ii)(a) of this section, both in -state and out-of-state clients 21
shall be counted in capacity for the purpose of obtaining a license from the 22
board and a permit from the Health Services Permit Agency or the Health 23
Services Permit Commission. 24
(4) Any new license or expansion of capacity by an 25
existing licensee of the board shall require a license and permit from the 26
Office of Long-Term Care or the Health Services Permit Agency. 27
28
SECTION 19. Arkansas Code § 9 -28-407(a)(5), concerning licenses 29
required and issued by the Child Welfare Agency Review Board, is amended to 30
read as follows: 31
(5)(A) A license issued by the board under this subchapter is 32
effective unless revoked, suspended, or terminated by the board. 33
(B) In addition to any other basis provided by law or 34
rule, the board shall terminate the license of a psychiatric residential 35
treatment facility licensee that has not been in operation for a consecutive 36 As Engrossed: H3/5/25 H3/31/25 HB1653
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twelve-month period. 1
(C) The Department of Human Services may recommend to the 2
board the revocation, suspension, or termination of a license for any basis 3
provided by law or rule, including without limitation the failure to be in 4
operation or in substantial compliance for a consecutive six -month period. 5
6
SECTION 20. Arkansas Code § 9 -28-407(f)(3)(F), concerning licenses 7
required and issued by the Child Welfare Agency Review Board, is amended to 8
read as follows: 9
(F) The provisions of subsection (a) of this section , 10
including those provisions regarding obtaining licenses or permits from the 11
Office of Long-Term Care and regarding obtaining any permits from the Health 12
Services Permit Agency or the Health Services Permit Commission, shall apply 13
in their entirety to the new owner of the child welfare agency 14
15
SECTION 21. Arkansas Code § 9 -28-416 is repealed. 16
9-28-416. Admission of children to psychiatric residential treatment 17
facilities. 18
(a) A psychiatric residential treatment facility licensed under this 19
subchapter and holding a permit from the Health Services Permit Agency or the 20
Health Services Permit Commission shall not admit a child for psychiatric 21
residential treatment unless the child is: 22
(1) An Arkansas resident; 23
(2) A child of a parent who is an Arkansas resident; 24
(3) A child placed by or on behalf of another state's child 25
welfare agency; 26
(4) A child for whom the facility is being paid by another 27
state's Medicaid program; 28
(5) A child of an active -duty member or veteran of the uniformed 29
services as defined in § 6 -4-302; or 30
(6) A nonresident child victim of human trafficking when the 31
regulated facility maintains responsibility for the return of the child to 32
the out-of-state custodian. 33
(b) The Department of Human Services may promulgate rules to enforce 34
this section. 35
36 As Engrossed: H3/5/25 H3/31/25 HB1653
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SECTION 22. Arkansas Code Title 9, Chapter 28, Subchapter 13, is 1
repealed. 2
Subchapter 13 — Psychiatric Residential Treatment Facilities and Other 3
Regulated Facilities 4
5
9-28-1301. Definitions. 6
As used in this subchapter: 7
(1) “Psychiatric residential treatment facility” means the same 8
as defined in § 9-28-402; and 9
(2) “Regulated facility” means: 10
(A) A psychiatric residential treatment facility licensed 11
under the Child Welfare Agency Licensing Act, § 9-28-401 et seq.; and 12
(B) A psychiatric hospital licensed under § 20 -9-201 et 13
seq., that admits a child for the purpose of providing behavioral health 14
treatment, regardless of whether the child is placed in an acute, subacute, 15
or otherwise unlicensed bed. 16
17
9-28-1302. Quality of care — Quality assurance reviews. 18
(a) The Department of Human Services shall promulgate rules setting 19
minimum standards and metrics governing the quality of care provided by a 20
regulated facility to a child. 21
(b) Quality of care standards shall include that a regulated facility 22
shall provide: 23
(1) Trauma-informed programming and clinical services and, when 24
applicable, evidence -based treatments; 25
(2) Services that will be short -term, target treatment episodes 26
to reduce the likelihood of re -entry into residential treatment settings; 27
(3) Services that are family -driven and youth-guided; 28
(4) Mental health services and clinical services provided by 29
clinical staff as appropriate for the child's needs; 30
(5) Educational services in compliance with state and federal 31
law and rules of the Department of Education; 32
(6) Coordination of all needs including medical, dental, and 33
other needs; and 34
(7) Clinical discharge planning throughout the child's stay that 35
includes the custodian and child involvement. 36 As Engrossed: H3/5/25 H3/31/25 HB1653
16 03-31-2025 13:35:19 JMB064
(c)(1) The Department of Human Services and its designees may inspect 1
and investigate the quality of care for behavioral health provided to any 2
child admitted to a regulated facility, whether or not the child is an 3
Arkansas resident. 4
(2) The Department of Human Services or any other public agency 5
having authority or responsibility with respect to child maltreatment, 6
including without limitation the Medicaid Fraud Control Unit of the Attorney 7
General's office, may investigate any alleged or suspected child maltreatment 8
in any regulated facility. 9
(d) The Department of Human Services shall conduct quality assurance 10
reviews for each regulated facility, consisting of the following: 11
(1) A review of treatment structure including without 12
limitation: 13
(A) Observation of paraprofessional and direct -care staff 14
interaction with patients; 15
(B) Review of daily activity structure outside of school 16
and treatment; 17
(C) Review of paraprofessional and direct -care staff 18
training and personnel records; 19
(D) Review of staff -to-client ratios; and 20
(E) Completion of client interviews; 21
(2) An analysis of referral data, statistics, and psychotropic 22
medication prescriptions; 23
(3) An on-site visit of a regulated facility's operation, to be 24
conducted at least once per year; and 25
(4) Technical assistance and ongoing quality assurance and 26
collaboration as needed. 27
(e) This subchapter does not require any additional licensure or 28
certification for a regulated facility. 29
30
9-28-1303. Department enforcement authority. 31
(a) The Department of Human Services may initiate an adverse action 32
against a regulated facility that: 33
(1) Fails to comply with the provisions of this subchapter or 34
any rule of the department relating to quality of care; 35
(2) Furnishes or makes any statement or report to the department 36 As Engrossed: H3/5/25 H3/31/25 HB1653
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that is false or misleading; 1
(3) Refuses or fails to submit required reports or to make 2
available to the department any records required by the department in making 3
an investigation of the agency for quality of care purposes; 4
(4) Refuses or fails to submit to an investigation or to 5
reasonable inspection by the department; 6
(5) Retaliates against an employee who in good faith reports a 7
suspected violation of the provisions of this subchapter or the rules 8
promulgated under this subchapter; 9
(6) Fails to engage in a course of professional conduct in 10
dealing with clients being served by the regulated facility, as defined by 11
rules promulgated under this subchapter; or 12
(7) Demonstrates gross negligence in carrying out the duties at 13
the regulated facility. 14
(b) The department may impose an adverse action as follows: 15
(1) Issue letters of reprimand or caution; 16
(2) Require a corrective action plan; and 17
(3)(A) Impose civil penalties of up to two thousand five hundred 18
dollars ($2,500) per violation, with each day of noncompliance and each 19
client injured as a result of noncompliance constituting a separate 20
violation. 21
(B) If any person upon whom the department has levied a 22
civil penalty fails to pay the civil penalty within sixty (60) days of the 23
decision of the department to impose the penalty, the amount of the fine 24
shall be considered to be a debt owed to the State of Arkansas and may be 25
collected by civil action. 26
(C) Civil penalties collected under this section may be 27
expended only for the purpose of providing technical assistance and training 28
to regulated facilities. 29
(c)(1) For a regulated facility licensed under the Child Welfare 30
Agency Licensing Act, § 9 -28-401 et seq., the department may petition the 31
Child Welfare Agency Review Board to deny, suspend, or revoke the regulated 32
facility's license on the basis of any adverse action imposed by the 33
department under this section. 34
(2) For a regulated facility licensed under § 20 -9-201 et seq., 35
the department may petition the State Board of Health to deny, suspend, or 36 As Engrossed: H3/5/25 H3/31/25 HB1653
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revoke the regulated facility's license on the basis of any adverse action 1
imposed by the department under this section. 2
(d) The department shall notify the regulated facility of the adverse 3
action of the department in writing and set forth the facts forming the basis 4
for the adverse action. 5
(e)(1) Adverse action hearings shall comply with the Arkansas 6
Administrative Procedure Act, § 25 -15-201 et seq. 7
(2) Within ten (10) business days after rendering a decision, 8
the department shall forward to the regulated facility written findings of 9
fact and conclusions of law articulating the decision of the department. 10
11
9-28-1304. Rules. 12
The Department of Human Services shall promulgate rules to implement 13
this subchapter. 14
15
SECTION 23. DO NOT CODIFY. TEMPORARY LANGUAGE. Rules. 16
(a) Beds within a psychiatric residential treatment facility, whether 17
licensed on the effective date of this act or otherwise, shall not be 18
approved and licensed under the new regulatory structure established in this 19
act until: 20
(1) The Office of Long -Term Care promulgates a certification 21
manual; and 22
(2) The Arkansas Medicaid Program promulgates a provider manual 23
for psychiatric residential treatment facility services. 24
(b) Providers of psychiatric residential treatment facility services 25
in this state shall have one (1) year from the effective date of this act to 26
develop, implement, and operate services that establish the appropriate 27
continuum of care for families as defined by the Department of Human 28
Services. 29
30
SECTION 24. EMERGENCY CLAUSE. It is found and determined by the 31
General Assembly of the State of Arkansas that beds in psychiatric 32
residential treatment facilities have been permitted but are not currently 33
licensed; that these beds in psychiatric residential treatment facilities 34
that are not licensed cannot be used for children in need of healthcare 35
services despite the demand for the beds; that this act would authorize 36 As Engrossed: H3/5/25 H3/31/25 HB1653
19 03-31-2025 13:35:19 JMB064
licensing of the beds in psychiatric residential treatment facilities and 1
therefore allow the use of these beds in psychiatric residential treatment 2
facilities for children in need; and that this act is immediately necessary 3
to provide healthcare services to children in need across this state who are 4
currently not able to be admitted into a psychiatric residential treatment 5
facility. Therefore, an emergency is declared to exist, and this act being 6
immediately necessary for the preservation of the public peace, health, and 7
safety shall become effective on: 8
(1) The date of its approval by the Governor; 9
(2) If the bill is neither approved nor vetoed by the Governor, 10
the expiration of the period of time during which the Governor may veto the 11
bill; or 12
(3) If the bill is vetoed by the Governor and the veto is 13
overridden, the date the last house overrides the veto. 14
15
/s/Cavenaugh 16
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APPROVED: 4/16/25 19
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