Ark. Code Ann. § 20-6-101 Title.
This subchapter shall be known and may be cited as the “Arkansas Healthcare Decisions Act”.
General Provisions
Ark. Code Ann. tit. 20, ch. 6
in effectArk. Code Ann. § 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)(A) “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.
(B) “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 § 9-35-109;
(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)(A) “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.
(B) “Healthcare institution” includes without limitation:
(i) An ambulatory surgical facility;
(ii) A birthing center;
(iii) A home health agency;
(iv) A hospital;
(v) An intermediate care facility for individuals with intellectual disabilities;
(vi) A mental health center;
(vii) An assisted living facility;
(viii) A nursing home;
(ix) An outpatient diagnostic center;
(x) A residential treatment facility;
(xi) A rehabilitation facility; and
(xii) 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)(A) “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.
(B) “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:
(A) A person authorized by law to consent on behalf of the principal when the principal is incapable of making an informed decision; or
(B) 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.
Ark. Code Ann. § 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.
(a)(1)(A) An adult, married minor, or emancipated minor may make healthcare decisions for himself or herself and give an individual instruction.
(B) 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.
(b)(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.
(c)(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.
(d) 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.
(e)(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.
(f)(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)(A) 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.
(B) In determining the principal's best interest, the agent shall consider the principal's personal values to the extent known to the agent.
(g) A healthcare decision made by an agent for a principal is effective without judicial approval.
(h) 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.
(i) 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.
Ark. Code Ann. § 20-6-104 Revocation of designation of agent — Revocation of advance directive — Spouse as agent — Conflicts.
(a) 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.
(b) 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.
(c) An advance directive that conflicts with an earlier advance directive revokes the earlier advance directive to the extent of the conflict.
(d) 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.
Ark. Code Ann. § 20-6-105 Designation of surrogate.
(a)(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.
(b) 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.
(c)(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:
(A) Lacks capacity;
(B) Has not appointed an agent or the agent is not reasonably available;
(C) Has not designated a surrogate or the surrogate is not reasonably available; and
(D) Does not have a guardian or the guardian is not reasonably available.
(2)(A) The principal's surrogate shall be an adult who:
(i) Has exhibited special care and concern for the principal;
(ii) Is familiar with the principal's personal values;
(iii) Is reasonably available; and
(iv) Is willing to serve.
(B) 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:
(A) Shall consider the proposed surrogate's:
(i) Ability to make decisions either in accordance with the known wishes of the principal or in accordance with the principal's best interests;
(ii) Frequency of contact with the principal before and during the incapacitating illness; and
(iii) Demonstrated care and concern; and
(B) May consider the proposed surrogate's:
(i) Availability to visit the principal during his or her illness; and
(ii) 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:
(A) The principal's spouse, unless legally separated;
(B) The principal's adult child;
(C) The principal's parent;
(D) The principal's adult sibling;
(E) Any other adult relative of the principal; or
(F) 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:
(A) Consults with and obtains the recommendations of an institution's ethics officers or ethics committee; or
(B) Obtains concurrence from a second physician who is:
(i) Not directly involved in the principal's health care;
(ii) Does not serve in a capacity of decision making, influence, or responsibility over the designated physician; and
(iii) Does not serve in a capacity under the authority of the designated physician's decision making, influence, or responsibility.
(6)(A) 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.
(B) 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.
(d)(1) Except as provided in subdivision (d)(2) of this section:
(A) 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
(B) 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:
(A) The employee so designated is a relative of the principal by blood, marriage, or adoption; and
(B) The other requirements of this section are satisfied.
(e) 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.
Ark. Code Ann. § 20-6-106 Authority of surrogate.
(a)(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)(A) Otherwise, the surrogate shall make the decision in accordance with the surrogate's determination of the principal's best interest.
(B) 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.
(b) 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:
(A) The provision or continuation of artificial nutrition or hydration is merely prolonging the act of dying; and
(B) The principal is highly unlikely to regain capacity to make medical decisions.
(c) A healthcare decision made by a surrogate or agent for a principal is effective without judicial approval.
(d)(1) A surrogate may apply for public benefits, such as Medicare and Medicaid, for the principal, subject to any federal restrictions or requirements, and to the extent required to make an application, may obtain records regarding the principal's income, assets, and banking and financial records on an account of which the principal is:
(A) The owner or co-owner; or
(B) A beneficiary, including without limitation a trust, guardianship, or conservatorship.
(2) The authority under subdivision (d)(1) of this section includes without limitation the ability to assist with, submit, and execute applications for benefits, redetermination of eligibility, and other ongoing related communications.
(3) The authority under subdivision (d)(1) of this section shall terminate when revoked by a principal who no longer lacks decisional capacity, upon appointment or availability of a power of attorney or guardian with such authority, or upon the death of the principal.
(4)(A) The authority under subdivision (d)(1) of this section shall only be exercised by the surrogate upon presentation of written designation signed by the principal or supervising healthcare provider as provided in § 20-6-105(c) that is either notarized or signed by two (2) non- familial witnesses.
(B) The written designation shall:
(i) Identify the principal;
(ii) Identify the designated surrogate;
(iii) State the date of the designation of the surrogate by the principal or by the supervising healthcare provider; and
(iv) If appointed by a supervising healthcare provider:
(a) Attest that the principal has been determined by a licensed physician to lack capacity and an agent or guardian has not been appointed or the agent or guardian is not reasonably available; and
(b) State that the written document is executed in conformance with this section for the purpose of allowing the surrogate to apply for public benefits on behalf of the principal.
(5) The authority under subdivision (d)(1) of this section to access records regarding the principal’s income and assets, including bank account and financial records, does not confer the authority to control, direct, or otherwise access the principal’s income, assets, or accounts upon the surrogate.
(6)(A) A person or entity to whom a written designation is presented as described in subdivision (d)(4) of this section may rely on the written designation if the written designation appears on its face to comply with this section.
(B) If the written designation does not appear on its face to comply with this section or if the recipient has reasonable cause to suspect the written designation does not comply with this section, the recipient may decline to provide the requested record.
(C) A person or entity that provides information or records, or both, to a surrogate under this section is not liable to the principal, surrogate, or other person or entity for providing the information or records, or both.
(7)(A) If bank account or financial records are sought for an account co-owned by the principal and another person or entity or an account of which the principal is a beneficiary, the bank or financial institution shall give written notice to the joint account holder or the signatory on the entity account of the request and allow them an opportunity to object in writing to the request within ten (10) business days.
(B) If the bank or financial institution does not receive a written objection within ten (10) business days of the date on the notice described in subdivision (d)(7)(A) of this section, the bank or financial institution may allow the surrogate to obtain the records if the request is otherwise in accordance with the requirements of this subchapter.
(C) If the bank or financial institution receives a written objection within ten (10) business days of the date of the notice described in subdivision (d)(7)(A) of this section, the bank or financial institution shall notify the surrogate of the objection and decline the request for records.
(8) Except as provided in subdivision (d)(7) of this section, the surrogate may receive only records which the principal would be entitled upon request to receive when making a request for records.
(9)(A) The records, materials, data, and information made available by a financial services provider are confidential and shall not be disclosed to any person other than as necessary to apply for public benefits on behalf of the principal.
(B) The surrogate shall securely destroy all copies of the information upon termination of the authority under subdivision (d)(3) of this section.
(C) Upon request, all information and records obtained by a surrogate under subdivision (d)(1) of this section shall be promptly and securely transferred to a properly appointed successor surrogate, power of attorney, or guardian or to a principal who no longer lacks decisional capacity.
(e) A surrogate shall meet all federal requirements to act as an authorized representative, including confidentiality provisions.
Ark. Code Ann. § 20-6-107 Requirement of guardian to comply with principal's individual instruction.
(a) 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.
(b) Except as provided in § 28-65-102, a healthcare decision made by a guardian for the principal is effective without judicial approval.
Ark. Code Ann. § 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.
Ark. Code Ann. § 20-6-109 Compliance by healthcare provider or institution.
(a) 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.
(b) A healthcare provider may decline to comply with an individual instruction or healthcare decision for reasons of conscience.
(c) 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.
(d) 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.
(e) 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)(A) 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.
(B) If a transfer cannot be effected, the healthcare provider or institution shall not be compelled to comply.
Ark. Code Ann. § 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.
Ark. Code Ann. § 20-6-111 Liability.
(a) 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.
(b) 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.
(c) 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.
(d) A person or entity that relies in good faith on a written surrogacy designation under this subchapter is not subject to civil or criminal liability, including any administrative proceeding, for providing the surrogate with access to records regarding the principal’s income, assets, and banking and financial accounts for the surrogate to make an application for public benefits on behalf of the principal.
Ark. Code Ann. § 20-6-112 Presumption of capacity.
(a) This subchapter does not affect the right of an individual to make healthcare decisions while having capacity to do so.
(b) 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.
Ark. Code Ann. § 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.
Ark. Code Ann. § 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.
(a) This subchapter does not create a presumption concerning the intention of an individual who has not made or who has revoked an advance directive.
(b) 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.
(c) 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.
Ark. Code Ann. § 20-6-115 Court jurisdiction.
(a) 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).
(b) A proceeding under this section shall be expedited on the court's civil dockets.
Ark. Code Ann. § 20-6-116 Effect and interpretation of living wills.
(a) If a living will entered into before October 1, 2013, was valid at the time of execution, it remains valid.
(b) 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.
(c) 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.
Ark. Code Ann. § 20-6-117 Effect and interpretation of durable powers of attorney.
(a) 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.
(b) 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.
(c) 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.
Ark. Code Ann. § 20-6-202 Legislative findings and purpose.
(a) 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.
(b) 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.
Ark. Code Ann. § 20-6-203 Definitions.
As used in this subchapter:
(1)(A) “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.
(B) “Entity” does not include insurance companies, health maintenance organizations, or hospital and medical service corporations;
(2)(A) “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.
(B) 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:
(i) The date that the healthcare provider's relationship with the entity terminates; or
(ii) The date that the healthcare provider gave the entity notice of a new practice location; and
(3) “Healthcare provider” means a person who:
(A) Is licensed by:
(i) The Arkansas State Medical Board;
(ii) The Arkansas State Board of Dental Examiners;
(iii) The Arkansas State Board of Nursing;
(iv) The Arkansas State Board of Chiropractic Examiners;
(v) The Arkansas Board of Podiatric Medicine; or
(vi) The State Board of Optometry; and
(B) Has ultimate responsibility and legal liability for the care of the patient.
Ark. Code Ann. § 20-6-204 Prohibited conduct.
(a) If a healthcare provider who is relocating his or her practice provides written notice of the healthcare provider's new practice location or contact information via certified mail to the chief executive or administrative officer, the entity or person on behalf of an entity shall not:
(1) Mislead any patient about the new practice location of a healthcare provider, new contact information of a healthcare provider, or the healthcare provider's licensure status; 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.
(b)(1) When requested by a healthcare provider who is relocating his or her practice in a written notice via certified mail to the chief executive or administrative officer, then an entity with a relationship with the healthcare provider shall within twenty-one (21) calendar days either:
(A) Provide the healthcare provider with a list of the healthcare provider's existing patient names and addresses; or
(B) 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;
(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.
Ark. Code Ann. § 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.
Ark. Code Ann. § 20-6-206 Injunctive relief.
(a) 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.
(b) Upon the filing of a complaint, the court may issue a temporary injunction on the violation without notice or bond.
(c) If the plaintiff patient or plaintiff 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.
(d) A prevailing plaintiff healthcare provider shall be entitled to:
(1) The greater of:
(A) Liquidated damages in the amount of one thousand dollars ($1,000) per day per violation, with a maximum of five hundred thousand dollars ($500,000); or
(B) Actual damages; and
(2) Reasonable attorney's fees and costs.
(e) A prevailing plaintiff patient or plaintiff patients collectively, as named plaintiffs or as a putative or named class, shall be entitled to:
(1) The greater of:
(A) Liquidated damages in the amount of one thousand dollars ($1,000) per day per violation, with a maximum of five hundred thousand dollars ($500,000) for all patients in any actions related to the same violation; or
(B) Actual damages; and
(2) Reasonable attorney's fees and costs.
(f) 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.
Ark. Code Ann. § 20-6-207 Applicability — Construction.
(a) 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.
(b) Any purported waiver of the benefits or requirements of this subchapter is void and against the public policy of this state.
Ark. Code Ann. § 20-6-301 Title.
This subchapter shall be known and may be cited as the “Arkansas Physician Order for Life-Sustaining Treatment Act”.
Ark. Code Ann. § 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:
(A) Is:
(i) Signed;
(ii) Immediately actionable as medical orders on a standardized form;
(iii) A conspicuous, clearly identifiable form; and
(iv) Recognized, adopted, and honored across treatment settings; and
(B) 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.
Ark. Code Ann. § 20-6-303 Definitions.
As used in this subchapter:
(1)(A) “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.
(B) “Healthcare facility” includes without limitation:
(i) An ambulatory surgical facility;
(ii) A home health agency;
(iii) A hospice;
(iv) A hospital;
(v) An infirmary;
(vi) A long-term care facility;
(vii) An assisted living facility;
(viii) A mental health center;
(ix) An outpatient facility;
(x) A rehabilitation facility; and
(xi) 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:
(A) An emergency medical care provider; and
(B) 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.
Ark. Code Ann. § 20-6-304 Physician order for life-sustaining treatment form.
(a) The State Board of Health shall prescribe a standardized physician order for life-sustaining treatment form that:
(1) Is signed and dated by:
(A) The patient or the legal representative of the patient; and
(B) The physician of the patient;
(2) Includes:
(A) The name and date of birth of the patient; and
(B) 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.
(b) 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.
(c)(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:
(A) Explain:
(i) The physician order for life-sustaining treatment form; and
(ii) The medical interventions and procedures offered by the life-sustaining treatment form; and
(B) 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.
(d) This subchapter does not authorize a physician to unilaterally create a physician order for life-sustaining treatment on behalf of an individual.
Ark. Code Ann. § 20-6-305 Compliance.
(a) 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.
(b) 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.
(c)(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:
(A) Promptly informs the patient or legal representative of the patient regarding the inability to carry out the physician order for life-sustaining treatment form;
(B) 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
(C)(i) 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.
(ii) 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.
Ark. Code Ann. § 20-6-306 Review and revision.
(a)(1) An executed physician order for life-sustaining treatment form may be reviewed periodically by the physician of the patient.
(2) The physician may:
(A) Conduct an evaluation of the patient; and
(B) 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.
(b)(1) The new physician order for life-sustaining treatment form shall be:
(A) Recorded on a new physician order for life-sustaining treatment form; and
(B) 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.
(c) 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.
(d) 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.
Ark. Code Ann. § 20-6-307 Relationship with advance directives.
(a)(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.
(b) 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.
(c) This section does not prohibit or require the execution, revocation, or modification of an advance directive.
Ark. Code Ann. § 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:
(A) The physician order for life-sustaining treatment form was not valid; or
(B) 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.
Ark. Code Ann. § 20-6-309 Voluntary signing.
(a) The signing of a physician order for life-sustaining treatment form by a patient or legal representative of the patient is voluntary.
(b)(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:
(A) Goals of care;
(B) Personal values and preferences;
(C) Benefits of various treatment options; and
(D) Avoidance of unwanted burden.
(c) 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.
Ark. Code Ann. § 20-6-310 Criminal penalty.
(a) 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)(A) Cause an individual to execute a physician order for life-sustaining treatment form by undue influence, fraud, or duress.
(B) As used in this section, “undue influence” includes without limitation:
(i) 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;
(ii) Requiring a healthcare provider to have an internal policy to offer a physician order for life-sustaining treatment form to any individual;
(iii) 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
(iv) 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.
(b) A person who violates this section is guilty of a Class D felony.
(c) 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.
Ark. Code Ann. § 20-6-311 Applicability — Death — Life insurance.
(a) 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.
(b)(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.
(c) 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.
Ark. Code Ann. § 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.
Ark. Code Ann. § 20-6-401 Title.
This subchapter shall be known and may be cited as the "No Patient Left Alone Act".
Ark. Code Ann. § 20-6-402 Legislative findings.
The General Assembly finds that:
(1) The coronavirus 2019 (COVID-19) pandemic has caused great uncertainty and anxiety across the state and has significantly affected the medical community, including hospitals;
(2) Healthcare facilities have made many efforts to maintain a safe environment for patients and employees and have worked to minimize, to the extent possible, the risk of spread of coronavirus 2019 (COVID-19);
(3) There have been unintended consequences of these preventative measures for patients who have not been diagnosed with coronavirus 2019 (COVID-19);
(4) Across the state, patients who have not been diagnosed with coronavirus 2019 (COVID-19) have been prohibited from having any visitors;
(5) As a result, many patients who were not diagnosed with coronavirus 2019 (COVID-19) have been required to be alone during their treatment for serious conditions, traumas, illnesses, and routine and emergency surgeries;
(6) Some of these patients have been required to be alone for the entire course of their treatment and in some cases have died alone;
(7) Many families have been unable to be physically present with their loved ones who are being treated in a healthcare facility and have been limited to electronic video communications, if any, with their loved ones; and
(8) It is in the interest of the state and its citizens that a patient be allowed at least one (1) support person who is permitted to be physically present with the patient on a daily basis at reasonable times throughout his or her hospitalization, visit to the office of a healthcare professional, or institutionalization.
Ark. Code Ann. § 20-6-403 Definitions.
As used in this subchapter:
(1)(A) “Compassionate care visitation” means a visit with a friend or family member that is necessary to meet the physical or mental needs of a resident when a resident is exhibiting signs of physical or mental distress, including without limitation:
(i) End-of-life situations;
(ii) Adjustment support after moving to a new facility or environment;
(iii) Emotional support after the loss of a friend or family member;
(iv) Physical support after eating or drinking issues, including weight loss or dehydration; or
(v) Social support after frequent crying, distress, or depression.
(B) "Compassionate care visitation" includes without limitation:
(i) Clergy members;
(ii) Lay persons offering religious or spiritual support;
(iii) Other persons requested by the resident for the purpose of a compassionate care visit; and
(iv) A person providing a service requested by the resident such as a hair dresser or barber;
(2) "Healthcare facility" means a hospital, an office of a healthcare professional, a long-term care facility, or a hospice facility;
(3) "Healthcare professional" 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;
(4) "Long-term care facility" means:
(A) A nursing home;
(B) A residential care facility;
(C) A post-acute head injury retraining and residential facility;
(D) An intermediate care facility for individuals with developmental disabilities;
(E) An assisted living facility; or
(F) A facility that provides long-term medical or personal care;
(5) "Other individuals given access" means persons other than patients and residents of a healthcare facility;
(6) "Patient with a disability" means a patient who needs assistance to effectively communicate with hospital staff, make healthcare decisions, or engage in activities of daily living due to a disability such as:
(A) A physical, intellectual, behavioral, or cognitive disability;
(B) Deafness, being hard of hearing, or other communication barriers;
(C) Blindness;
(D) Autism spectrum disorder; or
(E) Dementia; and
(7) "Support person" means an individual other than a spouse or legal guardian who is designated by the patient to advocate or provide support for the patient.
Ark. Code Ann. § 20-6-404 Visitation and support for a patient with a disability.
(a) Upon the request of a patient with a disability, a hospital, office of a healthcare professional, or hospice facility licensed in this state shall allow a patient with a disability to designate at least three (3) support persons and shall allow at least one (1) support person to be present with the patient with a disability at all times in the emergency department and during the stay of a patient with a disability in the hospital, office of a healthcare professional, or hospice facility if necessary to facilitate the care of the patient with a disability, including without limitation when the patient with a disability:
(1) Has a cognitive or mental health disability that affects the ability of a patient with a disability to make medical decisions or understand medical advice;
(2) Needs assistance with activities of daily living and the staff are unable to provide or are less effective at providing the assistance;
(3) Is deaf, hard of hearing, or has other communication barriers and requires the assistance of a support person to ensure effective communication with staff;
(4) Has behavioral health needs that the support person can address more effectively than the staff; or
(5) Is making a decision to consent to treatment or refuse treatment.
(b) A healthcare professional or healthcare facility shall not discriminate against a patient with a disability by requiring the patient with a disability to:
(1) Execute an advance directive or a physician order for life- sustaining treatment as a condition of receiving treatment or visitation; or
(2) Agree to a do-not-resuscitate or similar order as a condition of receiving treatment or visitation.
(c) This section does not affect any obligation of a healthcare professional or healthcare facility to:
(1) Provide patients with effective communication supports or other reasonable accommodations in accordance with federal and state laws; or
(2) Make exceptions to the visitor policy of a healthcare facility as a reasonable accommodation under the Americans with Disabilities Act of 1990, 42 U.S.C. § 12101 et seq., as existing on January 1, 2021.
Ark. Code Ann. § 20-6-405 Hospital or office of healthcare professional visitation.
(a)(1) A child has the right to have a parent, legal guardian, or person standing in loco parentis physically present with the child while the child receives care in a hospital or an office of a healthcare professional.
(2) An adult patient has the right to have a spouse, support person, or legal guardian physically present with the adult patient while the adult receives care in a hospital or an office of a healthcare professional.
(3) A person with a right to be physically present under subdivisions (a)(1) and (2) of this section may leave and return to the hospital or office of a healthcare professional that is caring for the patient.
(b) A hospital or an office of a healthcare professional shall not:
(1) Require a patient to waive the rights specified in subdivisions (a)(1) and (2) of this section;
(2) Prevent a parent, legal guardian, or person standing in loco parentis of a child receiving care in a hospital or an office of a healthcare professional from having daily physical access to the child at reasonable times; or
(3) Separate the parent, legal guardian, or person standing in loco parentis of a child receiving care in a hospital or an office of a healthcare professional from the child except in cases of suspected abuse or threats of violence or to prevent disruption to the care of the child.
(c) A hospital or an office of a healthcare professional may restrict access of any person to a patient:
(1) At the request of the patient or a law enforcement agency;
(2) Due to a court order;
(3) To prevent disruption to the care of the patient;
(4)(A) If the person has signs and symptoms of a transmissible infection.
(B) However, the hospital or office of a healthcare professional shall allow access through telephone, telecommunication means, or other means that ensure the protection of the patient.
(C) The person shall follow respiratory hygiene and cough etiquette as well as other infection prevention and control practices such as appropriate hand hygiene;
(5) If the person is determined to be a danger to the patient or to be contrary to the welfare of the patient; or
(6) According to visitation policies established under § 20-6-411.
Ark. Code Ann. § 20-6-406 Hospice facility visitation.
A patient who is receiving hospice care or the guardian, spouse, or support person of a patient who is receiving hospice care may designate additional family members and friends who may be physically present with the patient at reasonable times.
Ark. Code Ann. § 20-6-407 Long-term care facility visitation.
(a)(1) A long-term care facility shall allow compassionate care visitation as needed by the resident to alleviate physical or mental distress.
(2) Personal contact in person with a resident is permitted during a compassionate care visitation if the long-term care facility protocol is followed.
(3) A long-term care facility shall adopt a protocol for personal contact in person that adheres to appropriate infection prevention guidelines disseminated by the Centers for Disease Control and Prevention or the Centers for Medicare and Medicaid Services.
(b) A long-term care facility shall work with residents, families, caregivers, resident representatives, and medical providers, and may include the ombudsman program under § 20-10-602 to identify the need for compassionate care visitation, using a person-centered approach that takes the residents requests into account.
(c)(1) A long-term care facility shall ensure that decisions regarding end-of-life care are made by a resident with capacity or by the representative of a resident without capacity, as provided in the Arkansas Healthcare Decisions Act, § 20-6-101 et seq.
(2) Within the scope of visitation provided by this section, a long-term care facility shall permit a resident making decisions regarding end-of-life care to be accompanied by a family member, guardian, or support person designated by the resident, unless the resident declines or requests to have the discussion outside of the presence of a family member, guardian, or support person.
(d)(1) Compassionate care visitation shall continue even if the infection rate in the county in which the long-term care facility is located is high.
(2) However, a long-term care facility shall identify one (1) or more ways to allow a compassionate care visitation, including personal contact, that minimize the risk of infection to the resident and other residents in the long-term care facility.
(3)(A) In a long-term care facility with no new onset of coronavirus 2019 (COVID-19) in the last fourteen (14) days and in counties with coronavirus 2019 (COVID-19) positivity rates that are less than ten percent (10%), a long-term care facility shall accommodate and support indoor visitation for reasons beyond compassionate care visitation.
(B) A long-term care facility may limit:
(i) The number of visitors per resident at one (1) time based on the size of the building and physical space; and
(ii) Movement in the long-term care facility, such as requiring the visitor to go directly to the resident’s room or designated visitation area.
(C) Visits for residents who share a room shall not be conducted in a resident’s room, unless the health status of the resident prevents leaving the room
(e) Healthcare workers who are not employees of the long-term care facility but provide direct care to a resident in the long-term care facility, such as hospice workers, emergency medical services personnel, dialysis technicians, laboratory technicians, radiology technicians, and social workers, shall be permitted into the long-term care facility if proper infection control protocols are followed.
(f) A long-term care facility that fails to facilitate compassionate care visitation without adequate justification related to clinical necessity or resident safety may be in violation of 42 C.F.R. 483.10(f)(4), as it existed on January 1, 2021.
(g) To the extent permitted by state and federal law, the appropriate state agency or licensing board shall investigate and may penalize a long- term care facility’s failure to comply with this section.
Ark. Code Ann. § 20-6-408 Clergy member or lay person offering religious or spiritual support visitation.
(a) A clergy member or lay person offering religious or spiritual support may be physically present with a patient to pray with or offer spiritual support for the patient while the patient receives care in a healthcare facility.
(b) If a healthcare facility has a visitation policy that allows in- person visitation of any kind, the healthcare facility shall allow a clergy member to visit a patient who requests a visit in person or consents to be visited in person for religious purposes by a clergy member, including during a state of emergency.
(c) Notwithstanding any other provision of this chapter, when a patient's death is imminent, the healthcare facility shall allow a clergy member to visit a patient in person for religious purposes if:
(1) The patient requests or consents to be visited by the clergy member; or
(2) The patient's healthcare agent or support person requests that the patient be visited by the clergy member.
(d)(1) The healthcare facility may require the clergy member to comply with reasonable health and safety precautions, including reasonable health screenings and wearing personal protective equipment, imposed by the healthcare facility in connection with in-person visitation for the prevention of spreading communicable diseases unless the precaution substantially burdens the ability of the clergy member to freely exercise his or her religion.
(2) If the requirements substantially burdens the ability of the clergy member, the healthcare facility may require compliance with the precautions only if compliance in that instance furthers a compelling government interest and imposes the least restrictive burden on the clergy member’s exercise of religion.
(3) Notwithstanding any other provision in this chapter, a healthcare facility may restrict visits of a clergy member who fails a reasonable health screening measure or tests positive for a communicable disease.
(e)(1)(A) The protection afforded by this section is in addition to the protections provided under federal law, state law, and the state and federal constitutions.
(B) This section does not:
(i) Preempt or repeal any state or local law that is equally or more protective of clergy member visitation rights; or
(ii) Narrow the meaning or application of any state or local law protecting clergy member visitation.
(2)(A) This section applies to all state and local laws and ordinances and the implementation of those laws and ordinances, whether statutory or otherwise and whether adopted before or after the effective date of this section.
(B) State laws enacted after the effective date of this section are subject to this section unless the law explicitly excludes application by reference to this section.
Ark. Code Ann. § 20-6-409 Informational materials.
(a)(1) Within thirty (30) days of the effective date of this act, the Department of Health and the Department of Human Services shall develop informational materials regarding this subchapter.
(2) The Department of Health and the Department of Human Services shall present informational materials regarding this subchapter to the:
(A) Senate Committee on Public Health, Welfare, and Labor;
(B) House Committee on Public Health, Welfare, and Labor; and
(C) House Committee on Aging, Children and Youth, Legislative and Military Affairs.
(b) A healthcare facility shall make the informational materials regarding this subchapter accessible:
(1) Upon admission or registration; and
(2) On the website of the healthcare facility.
(c) Every sixty (60) days or upon the release of relevant federal guidelines, the Department of Health, with input from the long-term care industry and the hospital industry, shall reevaluate and update the directives where needed to allow for the maximum visitation possible under federal guidelines.
(d) Information and directives produced by this state that provide guidance about visitation shall take into consideration and include the highest amount possible of privacy and dignity for interaction between patients and visitors.
Ark. Code Ann. § 20-6-410 Complaints.
(a) An individual may file a complaint against a healthcare professional or healthcare facility for failing to comply with this subchapter with the appropriate state agency or licensing board, including the Department of Health and the Department of Human Services.
(b) The appropriate state agency or licensing board shall investigate the complaint.
Ark. Code Ann. § 20-6-411 Visitation limits or restrictions.
A healthcare facility may establish visitation policies that limit or restrict visitation when:
(1) The presence of visitors would be medically or therapeutically contraindicated;
(2) The presence of visitors would interfere with the care of or rights of any patient;
(3) Visitors are engaging in disruptive, threatening, or violent behavior toward any staff member, patient, or other visitor; or
(4) Visitors are noncompliant with healthcare facility policy.
Ark. Code Ann. § 20-6-412 Liability of healthcare facilities.
(a) Unless expressly required by federal law or regulation, a state survey agency or other state agency shall not take any action against a healthcare facility for:
(1) Giving a visitor or other individual access to a healthcare facility, clinic, or other similar location under this subchapter;
(2) Failing to protect or otherwise ensure the safety or comfort of a visitor or other individual given access to a healthcare facility, clinic, or other similar location under this subchapter;
(3) Failing to follow the Centers for Disease Control and Prevention or other national guidelines that require or recommend restricting visitor access; or
(4) The acts or omissions of any visitor or other individual who is given access to a healthcare facility, clinic, or similar location.
(b) This section does not apply to courts or the judicial branch.
Ark. Code Ann. § 20-6-413 Construction.
(a) This subchapter does not apply to:
(1) The Arkansas State Hospital;
(2) A minor who is:
(A) In the custody of the Division of Children and Family Services; or
(B) A suspected victim in a pending maltreatment investigation;
(3) An individual who is in the custody of the Department of Corrections; or
(4) An individual who is attending a preventive healthcare office visit during which evidence-based guidelines for preventive care recommend a confidential visit component for youth, as mutually agreed to by the patient and his or her physician.
(b) This subchapter does not:
(1) Affect the rights of a legal guardian or holder of a power of attorney; or
(2) Waive or change the long-term care facility residents' rights under § 20-10-1204.
(c) The requirements under this subchapter shall be established as a minimum for visitation in a healthcare facility but does not limit visitation at a healthcare facility to only visitation outlined in this subchapter.
(d) The rights specified in this subchapter shall not be terminated, suspended, or waived by:
(1) A healthcare facility;
(2) The Department of Health;
(3) The State Board of Health;
(4) The Department of Human Services; or
(5) The Governor upon declaring a disaster emergency under the Arkansas Emergency Services Act of 1973, § 12-75-101 et seq., or ordering the board to take action under § 20-7-110, or both.
Source: Public.Resource.Org / UniCourt, Official Code of Arkansas Annotated, Release 78 (2020) (unicourt.github.io/cic-code-ar)URL: https://unicourt.github.io/cic-code-ar/transforms/ar/ocar/r78/gov.ar.code.title.20.htmlFetched: 11/8/2026