Stricken language would be deleted from and underlined language would be added to present law.
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State of Arkansas 1
95th General Assembly A Bill 2
Regular Session, 2025 SENATE BILL 306 3
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By: Senator C. Penzo 5
By: Representative L. Johnson 6
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For An Act To Be Entitled 8
AN ACT TO REQUIRE THE DEPARTMENT OF HUMAN SERVICES TO 9
APPLY FOR A HOME- AND COMMUNITY-BASED SERVICES WAIVER 10
FOR THE AGING AND ELDERLY POPULATION IN THIS STATE; 11
AND FOR OTHER PURPOSES. 12
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Subtitle 15
TO REQUIRE THE DEPARTMENT OF HUMAN 16
SERVICES TO APPLY FOR A HOME - AND 17
COMMUNITY-BASED SERVICES WAIVER FOR THE 18
AGING AND ELDERLY POPULATION IN THIS 19
STATE. 20
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BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF ARKANSAS: 22
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SECTION 1. Arkansas Code Title 20, Chapter 77, Subchapter 1, is 24
amended to add an additional section to read as follows: 25
20-77-154. Home- and community-based services waiver for aging and 26
elderly populations. 27
(a) The General Assembly finds that: 28
(1)(A) The waivers within the state Medicaid programs for home - 29
and community-based services were first established by Section 2176 of the 30
Omnibus Budget Reconciliation Act of 1981, Pub. L. No. 97 -35, and were 31
incorporated into the United States Code at section 1915(c) of the Social 32
Security Act, 42 U.S.C. § 1396 et seq. 33
(B) The waivers for home - and community-based services 34
allow states to provide state Medicaid services to targeted populations to 35
avoid institutionalization by receiving comparable services in their homes or 36 SB306
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communities; 1
(2)(A) The Arkansas Medicaid Program currently administers two 2
(2) home- and community-based services under the authority of section 1915(c) 3
of the Social Security Act, 42 U.S.C. § 1396 et seq., for Medicaid 4
beneficiaries who are elderly or aging. 5
(B) The Arkansas Medicaid Program has not designated a 6
comprehensive and integrated strategy to support the quickly increasing 7
numbers of Arkansans needing services due to aging or elderly needs; 8
(3)(A) Skilled nursing facilities have always had a place in a 9
comprehensive approach to supporting the aging and elderly population. 10
(B) However, home- and community-based services are not 11
adequately meeting the needs of Arkansans to allow the population to age in 12
their homes or communities before the need for a skilled nursing facility; 13
(4) Cost neutrality is a requirement under section 1915(c) of 14
the Social Security Act, 42 U.S.C. § 1396 et seq., meaning that the average 15
per participant cost for home - and community-based services must be no more 16
costly than the average per person cost at a skilled nursing facility; 17
(5) However, a wide gap currently resides in both cost and 18
service array resulting in no true alternative for a Medicaid beneficiary to 19
receive care in his or her home or community before a skilled nursing 20
facility is required; 21
(6) For the fiscal year 2024, the average participant cost for a 22
skilled nursing facility was approximately one hundred two thousand four 23
hundred eighty-two dollars ($102,482); and 24
(7) The Arkansas Medicaid Program is not operating at cost 25
neutrality for Medicaid beneficiaries who are aging or elderly without 26
appropriate waivers under section 1915(c) of the Social Security Act, 42 27
U.S.C. § 1396 et seq. 28
(b) The Department of Human Services shall apply for a waiver under 29
the authority of section 1915(c) of the Social Security Act, 42 U.S.C. § 1396 30
et seq., for aging and elderly populations to allow Medicaid beneficiaries to 31
have an alternative to skilled nursing facility care. 32
(c) The department shall ensure that the average per capita 33
expenditures estimated in a fiscal year for home - and community-based 34
services waiver recipients does not exceed the average per capita expenditure 35
that would have been made to provide institutional services for recipients in 36 SB306
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the absence of the wavier. 1
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