Health Facilities and Services Generally

Ark. Code Ann. tit. 20, ch. 9

in effect

Ark. Code Ann. § 20-9-101 Professional health service personnel — Parity.

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

Ark. Code Ann. § 20-9-103 Pulse oximetry screening — Definition.

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

Ark. Code Ann. § 20-9-104 Nonparticipation in maintenance of licensure or maintenance of certification — Definitions.

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

Ark. Code Ann. § 20-9-105 Legislative findings — Notice of battery in second degree.

(a) The General Assembly finds that: (1) The healthcare needs of the citizens of Arkansas are served by over sixty-six thousand (66,000) licensed nurses in a wide array of clinical settings and levels of criticality; (2) Both national and state data present an upward trend in violence and incivility against nurses and other healthcare professionals in clinical settings; (3) On average, two (2) nurses are attacked every hour nationwide, with the Press Ganey National Database of Nursing Quality Indicators showing more than five thousand two hundred (5,200) nurses were attacked in the second quarter of 2022; and (4) It is in the best interest of patients for healthcare professionals, including nurses, to be able to perform their duties in a safe and caring environment. (b) A written notice of the felony status under § 5-13-202(a)(4)(E) of attacking a healthcare professional, including a nurse, shall be posted: (1) At entrances to a healthcare facility, emergency department, clinic, or long-term care facility that are used by patients and visitors; and (2) In a patient waiting area of a healthcare facility, emergency department, clinic, or long-term care facility. (c)(1) The Arkansas Nurses Association shall provide the Department of Health a digital poster design that shall be used by a healthcare facility. (2) The text of the digital poster described under subdivision (c)(1) of this section shall read: "We respect you. Please respect our staff. Attacking a healthcare worker is a FELONY*. *Arkansas Code Annotated § 5-13-202."

Ark. Code Ann. § 20-9-201 Definitions.

As used in this subchapter: (1) “Administrator” means the chief administrative officer in the Division of Health Facilities Services; (2) “Alcohol and drug abuse inpatient treatment center” means a distinct unit within a hospital facility in which services are provided for the diagnosis, treatment, and rehabilitation of alcohol and drug abuse; (3) “Federal act” means the Hospital Survey and Construction Act, Pub. L. No. 79-725; (4)(A) “Hospital” means a public health center, a general, tuberculosis, mental, or chronic disease hospital, or a related facility such as a laboratory, outpatient department, nurses home or training facility, or a central service facility operated in connection with a hospital. (B) “Hospital” does not include an establishment: (i) Furnishing primarily domiciliary care; or (ii) Licensed or certified by the Division of Aging, Adult, and Behavioral Health Services of the Department of Human Services as an alcohol and drug abuse inpatient treatment center; (5)(A) “Institution” means a place for the diagnosis, treatment, or care of two (2) or more persons not related to the proprietor, suffering from illness, injury, or deformity, or where obstetrical care or care of the aged, blind, or disabled is rendered over a period exceeding twenty-four (24) hours. (B) “Institution” also includes an outpatient surgery center, outpatient psychiatric center, and infirmary. (C) “Institution” does not include an establishment: (i) Operated by the United States Government or by any of its agencies; or (ii) Licensed or certified by the Division of Aging, Adult, and Behavioral Health Services of the Department of Human Services as an alcohol and drug abuse inpatient treatment center; (6) “Medical facility” means a diagnostic or diagnostic and treatment center, or rehabilitation facility, as these terms are defined in the federal act, and any other medical facility for which federal aid may be authorized under federal law; (7) “Nonprofit hospital” or “nonprofit medical facility” means a hospital or medical facility owned and operated by one (1) or more persons or a corporation or association, no part of the net earnings of which inures to the benefit of any shareholder or individual; (8)(A) “Outpatient psychiatric center” means a facility in which psychiatric services are offered for a period of eight (8) to sixteen (16) hours a day, and where, in the opinion of the attending psychiatrist, hospitalization, as defined in the present licensure law, is not necessary. (B) “Outpatient psychiatric center” does not include community mental health clinics and centers as they now exist; (9)(A) “Outpatient surgery center” means a facility in which surgical services are offered that require the use of general or intravenous anesthetics and where, in the opinion of the attending physician, hospitalization, as defined in the present licensure law, is not necessary. (B) “Outpatient surgery center” does not include: (i) A medical office owned and operated by a physician or more than one (1) physician licensed by the Arkansas State Medical Board, if the medical office does not bill facility fees to a third party payor; or (ii) A dental office that has a Facility Permit for Moderate Sedation or a Facility Permit for General/Deep Sedation issued by the Arkansas State Board of Dental Examiners; (10) “Public health center” means a publicly owned facility for the provision of public health services and includes related facilities such as laboratories, clinics, and administrative offices operated in connection with public health centers; (11)(A) “Recuperation center” means an establishment with permanent facilities that include inpatient beds, with an organized medical staff, and with medical services including physicians' services and continuous nursing services to provide treatment for patients who are not in an acute phase of illness but who currently require primarily convalescent or restorative service that is usually post-acute hospital care of relatively short duration. (B) “Recuperation center” does not include an establishment furnishing primarily domiciliary care; and (12) “Surgeon General” means the United States Surgeon General. (13) “Rural emergency hospital” means an establishment that: (A) Meets the eligibility requirements described in this subchapter; (B) Provides rural emergency hospital services; (C) Provides rural emergency services in the facility twenty-four (24) hours per day by maintaining an emergency department that is staffed twenty-four (24) hours per day and seven (7) days per week with a physician, nurse practitioner, clinical nurse specialist, or physician assistant; (D) Has a transfer agreement in effect with a Level I or Level II trauma center; and (E) Meets other requirements as the Department of Health finds necessary: (i) In the interest of the health and safety of individuals who receive rural emergency hospital services; and (ii) For implementation of a state licensure that satisfies requirements for reimbursement by federal healthcare programs as a rural emergency hospital; and (14) “Rural emergency hospital services” means the following services provided by a rural emergency hospital that do not require more than twenty-four (24) hours on average in a rural emergency hospital: (A) Emergency department services and observation care; and (B) At the election of the rural emergency hospital, other medical and health services provided on an outpatient basis as specified in regulations adopted by the United States Secretary of Health and Human Services and authorized by the Department of Health.

Ark. Code Ann. § 20-9-202 Penalties.

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

Ark. Code Ann. § 20-9-203 Injunction.

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

Ark. Code Ann. § 20-9-204 Administration by Division of Health Facilities Services.

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

Ark. Code Ann. § 20-9-205 Powers and duties of State Board of Health.

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

Ark. Code Ann. § 20-9-206 Construction program — Survey and planning activities.

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

Ark. Code Ann. § 20-9-207 Construction program — Federal funds for surveying and planning.

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

Ark. Code Ann. § 20-9-208 Construction program — State plan.

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

Ark. Code Ann. § 20-9-209 Construction program — Application for funds.

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

Ark. Code Ann. § 20-9-210 Construction program — Payment of installments.

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

Ark. Code Ann. § 20-9-211 Construction program — Federal funds.

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

Ark. Code Ann. § 20-9-212 Minimum standards for hospitals and other institutions.

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

Ark. Code Ann. § 20-9-213 License required — Administration by State Board of Health.

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

Ark. Code Ann. § 20-9-214 Issuance of license — Fees.

(a) The State Board of Health shall issue licenses for the operation of institutions, subject to this subchapter, when the institutions are found to comply with the provisions of this subchapter and such rules as are lawfully promulgated by the Department of Health. (b) The Department of Health may levy and collect the following annual fees for issuance of an annual license to hospitals or institutions: Per facility (unless otherwise noted) (1) Hospitals (per bed) $ 6.00 (2) Ambulatory Surgery Center 1,000.00 (3) Rural Emergency Hospital 500.00 (4) Hospital-Based Recuperation Center 275.00 (5) Freestanding Recuperation Center 2,000.00 (6) Hospital-Based Alcohol/Drug Unit 75.00 (7) Freestanding Alcohol/Drug Unit 1,000.00 (8) Hospital-Based Outpatient Psychiatric Center 75.00 (9) Freestanding Outpatient Psychiatric Center 1,000.00 (10) Infirmary 100.00 (11) Reissuance of license due to name/address change 100.00 (c)(1) Applicants for license shall file applications under oath with the Department of Health upon forms prescribed by the Department of Health and shall pay an annual license fee as set forth in subsection (b) of this section, which shall be paid into the State Treasury or refunded to the applicant if a license is denied. (2)(A) The application shall be signed by the owner, if an individual or partnership, in the case of a corporation by two (2) of its officers, or in the case of a governmental unit by the head of the governmental department having jurisdiction over it. (B) Applications shall set forth the full name and address of the institution for which the license is sought and such additional information as the Department of Health may require, including affirmative evidence of ability to comply with such reasonable standards and rules as may be lawfully prescribed in this subchapter. (3) Applications for annual license renewal shall be postmarked no later than January 2 of the succeeding calendar year. License applications for existing institutions received after January 2 shall be subject to a penalty of one dollar ($1.00) per day for each day after January 2. (d)(1) Licenses issued under this section shall be effective on a calendar-year basis and shall expire on December 31 of each calendar year. (2) A license shall be issued only for the premises and persons in the application and shall not be transferable. (3) Licenses shall be posted in a conspicuous place on the licensed premises. (e) All fees levied and collected under this subchapter are special revenues and shall be deposited into the State Treasury, there to be credited to the Public Health Fund. (f) Subject to such rules as may be implemented by the Chief Fiscal Officer of the State, the disbursing officer for the Department of Health may transfer all unexpended funds relative to the health facility services that pertain to fees collected, as certified by the Chief Fiscal Officer of the State, to be carried forward and made available for expenditures for the same purpose for any following fiscal year. Per facility FY '98 FY '99 (unless otherwise noted) (1) Hospitals (per bed) $ 4.00 $ 6.00 (2) Ambulatory Surgery Center 1,000.00 1,000.00 (3) Hospital-Based Recuperation Center 160.00 275.00 (4) Freestanding Recuperation Center 2,000.00 2,000.00 (5) Hospital-Based Alcohol/Drug Unit 60.00 75.00 (6) Freestanding Alcohol/Drug Unit 1,000.00 1,000.00 (7) Hospital-Based Outpatient Psychiatric Center 60.00 75.00 (8) Freestanding Outpatient Psychiatric Center 1,000.00 1,000.00 (9) Infirmary 100.00 100.00 (10) Reissuance of license due to name/address change 100.00 100.00 Click to view table.

Ark. Code Ann. § 20-9-215 License — Denial, suspension, and revocation.

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

Ark. Code Ann. § 20-9-216 License — Judicial review.

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

Ark. Code Ann. § 20-9-217 Alterations, additions, and new construction of facilities.

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

Ark. Code Ann. § 20-9-218 Emergency services facilities.

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

Ark. Code Ann. § 20-9-219 Inspections of facilities — Definitions.

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

Ark. Code Ann. § 20-9-220 Annual report.

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

Ark. Code Ann. § 20-9-221 Information confidential.

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

Ark. Code Ann. § 20-9-222 Certification fee.

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

Ark. Code Ann. § 20-9-223 Medical office licensure.

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

Ark. Code Ann. § 20-9-224 Rural emergency hospitals.

(a) A healthcare facility shall be eligible to apply for a rural emergency hospital license if the healthcare facility on or before December 27, 2020, was a: (1) Licensed critical access hospital; (2) General hospital with not more than fifty (50) licensed beds located in a county in a rural area under 42 U.S.C. § 1395ww(d)(10)(C)(ii); or (3) General hospital with not more than fifty (50) licensed beds that is deemed as being located in a rural area under 42 U.S.C. § 1395ww(d)(8)(E). (b) A healthcare facility applying for licensure as a rural emergency hospital shall include with the licensure application: (1) An action plan for initiating rural emergency hospital services, including a detailed transition plan that lists the specific services that the healthcare facility shall retain, modify, add, or discontinue, or any combination of retain, modify, add, or discontinue; (2) A description of services that the healthcare facility intends to provide on an outpatient basis; and (3) Other information as required by rules adopted by the Department of Health. (c) A rural emergency hospital shall not have inpatient beds unless the rural emergency hospital has a unit that is a distinct part of the rural emergency hospital that (1) Is licensed as a skilled nursing facility to provide post- hospital extended care services; or (2) Provides behavioral health services in accordance with the Arkansas Health and Opportunity for Me Act of 2021, § 23-61-1001 et seq. (d) A rural emergency hospital may own and operate an entity that provides ambulance services. (e)(1) A licensed general hospital or critical access hospital that applies for and receives licensure as a rural emergency hospital and elects to operate as a rural emergency hospital shall retain its original license as a general hospital or critical access hospital. (2) The original license shall remain inactive while the rural emergency hospital license is in effect. (f)(1) A rural emergency hospital, including a city, county, or other governmental or quasi-governmental hospital, may enter into any contracts required to be eligible for federal reimbursement as a rural emergency hospital. (2)(A) An entity engaging in activities and entering into contracts required to meet the requirements for licensure and reimbursement as a rural emergency hospital and its officers, agents, representatives, employees, and directors are acting pursuant to clearly expressed state policy under the supervision of the state. (B) An entity is not subject to state or federal antitrust laws while acting in this manner. (g) The State Board of Health shall adopt rules establishing the minimum standards for the establishment and operation of rural emergency hospitals in accordance with this section, including licensure of rural emergency hospitals. (h)(1) A health benefit plan that is offered, issued, or renewed in this state shall provide benefits and coverage for services performed by a rural emergency hospital if the services would be covered under the health benefit plan if performed by a general hospital. (2) As used in subdivision (h)(1) of this section, "health benefit plan" means the same as defined in § 23-79-1801. (i) The Arkansas Medicaid Program shall reimburse a rural emergency hospital at the same or greater rate in which critical access hospitals are reimbursed.

Ark. Code Ann. § 20-9-301 Posting of room rates.

(a) All public and private hospitals located and operated in this state shall post in some conspicuous place in each patient's room the daily room rates for both a private and a semiprivate room. (b) Any hospital or person violating subsection (a) of this section shall be guilty of a violation and upon conviction shall be subject to a fine of not less than ten dollars ($10.00) nor more than fifty dollars ($50.00) for each violation.

Ark. Code Ann. § 20-9-302 Abortion clinics, health centers, etc.

(a)(1)(A) A hospital shall not perform an abortion unless the abortion is to save the life of the pregnant woman in a medical emergency. (B)(i) A hospital shall not perform an abortion unless the abortion is to save the life of the pregnant woman in a medical emergency under § 5-61-304 or § 5-61-404. (ii) An abortion permitted under § 5-61-304 or § 5-61-404 shall not be performed or attempted unless the abortion takes place in a hospital or an emergency room. (1) Save the life or preserve the health of the unborn child; (2) Remove a dead unborn child caused by spontaneous abortion; or (3) Remove an ectopic pregnancy; and (ii) “Medical emergency” means a condition in which an abortion is necessary to preserve the life of a pregnant woman whose life is endangered by a physical disorder, physical illness, or physical injury, including a life-endangering physical condition caused by or arising from the pregnancy. (2) Remove a dead unborn child caused by spontaneous abortion; or (3) Remove an ectopic pregnancy; and (ii) "Medical emergency" means a condition in which an abortion is necessary to preserve the life of a pregnant woman whose life is endangered by a physical disorder, physical illness, or physical injury, including a life-endangering physical condition caused by or arising from the pregnancy. (2)(A) The department shall inspect a clinic, health center, or other facility at least annually, and inspections shall include without limitation: (i) The facilities, equipment, and conditions of a clinic, health center, or other facility; and (ii) A representative sample of procedures, techniques, medical records, informed consent signatures, and parental consent signatures. (B) An inspector shall arrive at the clinic, health center, or other facility unannounced and without prior notice. (b) The department shall: (1) Adopt appropriate rules, regarding without limitation the facilities, equipment, procedures, techniques, medical records, informed consent signatures, parental consent signatures, and conditions of a clinic, health center, or other facility subject to the provisions of this section to assure at a minimum that: (A) The facilities, equipment, procedures, techniques, and conditions of the clinic, health center, or other facility are aseptic and do not constitute a health hazard; (B) The medical records, informed consent signatures, and parental consent signatures meet statutory requirements; (C) The clinic, health center, or other facility provides to the patient on a twenty-four-hour basis telephone consultation with a registered nurse or physician associated with the clinic, health center, or other facility; (D) The clinic, health center, or other facility has a written procedure for emergency transfer of a patient to an acute care facility, including a medical record form that contains information required for an emergency transfer to an acute care facility; (E) The clinic, health center, or other facility is within thirty (30) miles of a hospital that provides gynecological or surgical services; (F) The clinic, health center, or other facility has drugs, oxygen, intravenous fluids, and other emergency equipment on-site and readily available to stabilize a patient if necessary; and (G) All staff at the clinic, health center, or other facility have documented current competency in cardiopulmonary resuscitation; (2) Levy and collect an annual fee of five hundred dollars ($500) per facility for issuance of a permanent license to an abortion facility; and (3)(A) Deny, suspend, or revoke licenses on any of the following grounds: (i) The violation of any provision of law or rule; or (ii) The permitting, aiding, or abetting of the commission of any unlawful act in connection with the operation of the institutions. (B)(i) If the department determines to deny, suspend, or revoke a license, the department shall send to the applicant or licensee, by certified mail, a notice setting forth the particular reasons for the determination. (ii) The denial, suspension, or revocation shall become final thirty (30) days after the mailing of the notice unless the applicant or licensee gives written notice within the thirty-day period of a desire for hearing. (iii)(a) The department shall issue an immediate suspension of a license if an investigation or survey determines that: (1) The applicant or licensee is in violation of any state law or rule; and (2) The violation or violations pose an imminent threat to the health, welfare, or safety of a patient. (b)(1) The department shall give the applicant or licensee written notice of the immediate suspension. (2) The suspension of the license is effective upon the receipt of the written notice. (iv) The denial, suspension, or revocation order shall remain in effect until all violations have been corrected. (C) The applicant or licensee shall: (i) Be given a fair hearing; and (ii) Have the right to present evidence as may be proper. (D)(i) On the basis of the evidence at the hearing, the determination involved shall be affirmed or set aside. (ii) A copy of the decision, setting forth the finding of facts and the particular grounds upon which it is based, shall be sent by certified mail to the applicant or licensee. (iii) The decision shall become final fifteen (15) days after it is mailed unless the applicant or licensee, within the fifteen-day period, appeals the decision to the court. (E) A full and complete record of all proceedings shall be kept and all testimony shall be reported, but it need not be transcribed unless the decision is appealed or a transcript is requested by an interested party who shall pay the cost of preparing the transcript. (F) Witnesses may be subpoenaed by either party and shall be allowed fees at a rate prescribed by rule. (G) The procedure governing hearings authorized by this section shall be in accordance with rules promulgated by the department. (c)(1) Applicants for a license shall file applications upon such forms as are prescribed by the department. (2) A license shall be issued only for the premises and persons in the application and shall not be transferable. (d)(1) A license shall be effective on a calendar-year basis and shall expire on December 31 of each calendar year. (2) Applications for annual license renewal shall be postmarked no later than January 2 of the succeeding calendar year. (3) License applications for existing institutions received after that date shall be subject to a penalty of two dollars ($2.00) per day for each day after January 2. (e) Subject to such rules as may be implemented by the Chief Fiscal Officer of the State, the disbursing officer for the department may transfer all unexpended funds relative to the abortion clinics that pertain to fees collected, as certified by the Chief Fiscal Officer of the State, to be carried forward and made available for expenditures for the same purpose for any following fiscal year. (f) All fees levied and collected under this section are special revenues and shall be deposited into the State Treasury to be credited to the Public Health Fund. (g) The department shall: (1) Send all abortion data collected under state law to the Centers for Disease Control and Prevention; (2) Record and report to the Centers for Disease Control and Prevention all instances of a suspension of a physician's license related to abortions or abortion facilities; and (3) Make available to the public via the Division of Vital Records the following information: (A) All abortion data collected under state law; and (B) All instances of a suspension of a physician's license related to abortions or abortion facilities. (h)(1) A person who notifies an abortion facility that the department may or will conduct its inspection on a specific date or time shall be guilty upon conviction of a Class A misdemeanor. (2) A person who knowingly conceals or removes information that is relevant to an inspection of an abortion facility shall be guilty upon conviction of a Class A misdemeanor. (i) All inspections of abortion facilities shall be conducted by at least two (2) persons at the same time.

Ark. Code Ann. § 20-9-304 Use of records for medical research.

(a) All information, interviews, reports, statements, memoranda, or other data of the State Board of Health, the Arkansas Medical Society, allied medical societies, or in-hospital staff committees of licensed hospitals, but not the original medical records pertaining to the patients, used in the course of medical studies for the purpose of reducing morbidity or mortality, as provided in this section, shall be strictly confidential and shall be used only for medical research. (b) Any authorized person, hospital, sanatorium, nursing home, rest home, or other organization may provide information, interviews, reports, statements, memoranda, or other data relating to the condition and treatment of any person to any of the following for use in the course of studies for the purpose of reducing morbidity or mortality: (1) The board; (2) The Arkansas Medical Society or any committee or allied society thereof; (3) Any other national medical organization approved by the board or any committee or allied medical society therein; or (4) Any in-hospital staff committee of licensed hospitals. (c) No liability for damages or other relief shall arise or be enforced against any authorized person, institution, or organization for: (1) Providing the information or material; (2) Releasing or publishing the findings and conclusions of the groups to advance medical research and medical education; or (3) Releasing or publishing generally a summary of the studies. (d)(1) The identity of the person whose condition or treatment has been studied shall be confidential and shall not be revealed under any circumstances. (2) Any information furnished shall not contain the name of the person upon whom information is furnished and shall not violate the confidential relationship of patient and doctor. (e)(1) Except for the original medical records pertaining to the patient, all information, interviews, reports, statements, memoranda, or other data furnished under this section and any findings or conclusions resulting from the studies are declared to be privileged communications that may not be used or offered or received in evidence in any legal proceeding of any kind. (2) Except for the original medical records pertaining to the patient, any attempt to use or offer the information, interviews, reports, statements, memoranda or other data, findings, or conclusions, or any part thereof, shall constitute prejudicial error in any proceeding unless waived by the interested parties. (f)(1) Physicians and others appointed to hospital utilization review committees for the purpose of determining the optimum use of hospital services shall be immune from liability with respect to decisions made as to utilization and actions thereunder so long as the physicians or others act in good faith. (2) However, nothing in this section shall be construed to relieve any patient's personal physician of any liability which he or she may have in connection with the treatment of the patient. (g) Nothing in this section shall be construed to prevent any court from subpoenaing the medical records of any patient.

Ark. Code Ann. § 20-9-305 Annual reports — Nonprofit hospitals.

(a)(1) Any nonprofit hospital association or corporation organized under the laws of this state that operates and maintains a hospital facility in this state primarily for providing hospital services for the employees of any corporation or company engaged in interstate commerce shall file annually with the Secretary of the Department of Finance and Administration a detailed report of income, fees, charges, and contributions from all sources received by it during the year, together with the expenses and disbursements of the corporation or association during the year. (2) The report shall be filed on or before April 1 in each year. (3) A copy of the report shall be furnished to each member of the hospital association or corporation upon the request of any member. (b) Any nonprofit hospital association or corporation failing or refusing to file the report as required in subsection (a) of this section or which fails or refuses to furnish any member a copy of the report or statement upon request shall be guilty of a violation and shall be subject to a fine of ten dollars ($10.00) for each day that the violation continues. (c)(1) The provisions of this section shall not apply to any nonprofit hospital association or corporation that operates and maintains a hospital facility in any county of this state having a population of not less than twenty-five thousand six hundred (25,600) nor more than twenty-five thousand seven hundred (25,700), according to the 1970 Federal Decennial Census. (2) The provisions of this section shall not be applicable with respect to any nonprofit hospital associations or corporations that operate and maintain a hospital facility in any county of this state having a population of not less than forty-seven thousand (47,000) nor more than fifty thousand (50,000), according to the 1970 Federal Decennial Census.

Ark. Code Ann. § 20-9-306 Annual reports — Public-supported hospitals.

(a) All public-supported hospitals in the State of Arkansas shall publish an annual report including financial statements showing profits, expenditures, and operating costs. (b) Every such hospital shall publish its annual report in a newspaper of general circulation within the county where it is located.

Ark. Code Ann. § 20-9-307 Itemized statement for services, drugs, and supplies.

(a)(1) Upon the patient's request at the time of discharge of each patient or at the time of billing the patient or the insurance company for the patient or at the time of billing the patient or the insurance company for the hospital services, drugs, and supplies, each hospital in the state, except those operated by the State of Arkansas, shall furnish to the patient and to the insurance company an itemized listing of all services, drugs, and supplies to be billed to that person while a patient in the hospital. (2) The itemized statement shall be furnished to the patient and the insurance company no later than thirty (30) days after discharge of the patient. (3) In addition, at the time of discharge each patient discharged from a hospital in this state shall be advised in writing of his or her right to receive the itemized statement for services, drugs, and supplies required by this section. (4) The State Board of Health shall adopt rules specifying the items to be included and the manner in which they shall be presented on itemized statements as required in this section. (b) The administrator or the agent of any hospital who fails or refuses to provide the itemized statement upon request as required in this section or fails or refuses at the time of discharge of any patient to advise the patient of his or her right to receive the itemized statement provided in this section shall be guilty of a violation and upon conviction shall be subject to a fine of not less than fifty dollars ($50.00) nor more than one hundred fifty dollars ($150) for each violation.

Ark. Code Ann. § 20-9-308 Advice by hospital employees to reviewing committees.

When requested, any physician, surgeon, hospital administrator, nurse, technologist, and any other person engaged in work in or about a licensed hospital and having any information or knowledge relating to the medical and hospital care provided in the hospital or to the efficient use of the hospital facilities shall be obligated to advise committees reviewing such matters with respect to all the facts or information possessed by the individual with reference to such care or use.

Ark. Code Ann. § 20-9-309 Emergency Medical Care Act — Definitions.

(a) This section may be cited as the “Emergency Medical Care Act”. (b) Because of the need for rapid assessment and care, in order to protect the life and health of the people of Arkansas during a medical emergency, it is found and declared necessary: (1) To establish a definition for emergency medical care; (2) To ensure that emergency medical care is provided in a timely manner by licensed and qualified personnel at a hospital's emergency department; and (3) To ensure that emergency medical care is not delayed or denied based on: (A) A person's ability to pay for expenses incurred during a medical emergency; or (B) Prospective authorization of treatment by an insurance company, health maintenance organization, hospital medical service corporation, health benefit plan, or any other insurer. (c) As used in this section: (1) “Emergency medical care” means healthcare services provided in a hospital emergency facility to evaluate and treat medical conditions of a recent onset and severity, including, but not limited to, severe pain that would lead a prudent lay person, possessing an average knowledge of medicine and health, to believe that his or her condition, sickness, or injury is of such a nature that failure to get immediate medical care could result in: (A) Placing the patient's health in serious jeopardy; (B) Serious impairment to bodily functions; or (C) Serious dysfunction of any bodily organ or part; (2) “Emergency medical provider” means a hospital licensed by the Department of Health, hospital-based services or a physician licensed by the Arkansas State Medical Board who provides emergency medical care; and (3) “Prospective authorization” means contacting any insurer, health maintenance organization, hospital medical service corporation, or health benefit plan that is not physically present in the hospital's emergency department at the time the patient presents for emergency medical care for approval or authorization to evaluate and treat the patient. (d)(1) Once a person qualifying for emergency medical care presents to an emergency department, that person shall be evaluated by medical personnel. This evaluation may include diagnostic testing to assess the extent of the condition, sickness, or injury and radiographic procedures and interpretations by a radiologist. (2) Appropriate intervention may be initiated by medical personnel to stabilize any condition presenting under this section before receiving authorization for the treatment by an insurer, health maintenance organization, hospital medical service corporation, or health benefit plan.

Ark. Code Ann. § 20-9-310 No liability for furnishing medical records or accessing information pursuant to subpoena or other legal obligation or authority.

Notwithstanding any other law to the contrary, no person or medical facility serving as a custodian of health or medical records shall be subject to any civil or criminal liability for: (1) Providing access to or producing copies of the records pursuant to a subpoena issued by any board, agency, commission, prosecuting attorney, or grand jury; (2) Providing access to or producing a copy of the health or medical records requested by a clerk of a court, the Division of Correction, the Division of Community Correction, the Arkansas State Hospital, the Department of Health, the Department of Human Services, or a local law enforcement agency under the Sex Offender Registration Act of 1997, § 12-12-901 et seq.; or (3) Requesting or accessing information under § 17-80-116.

Ark. Code Ann. § 20-9-311 Findings — Definitions.

(a) The General Assembly finds that: (1) Numerous workers who are occupationally exposed to blood-borne pathogens have contracted fatal and other serious viruses and diseases, including the human immunodeficiency virus (HIV), hepatitis B, and hepatitis C, from exposure to blood and other potentially infectious materials in their workplaces; (2) In 1991, the United States Occupational Safety and Health Administration issued a standard regulating occupational exposure to blood-borne pathogens including the human immunodeficiency virus (HIV), the hepatitis B virus, and the hepatitis C virus; (3) Compliance with the blood-borne pathogens standard has significantly reduced the risk that workers will contract a blood-borne disease in the course of their work; (4) Nevertheless, occupational exposure to blood-borne pathogens from accidental sharps injuries in healthcare settings continues to be a serious problem; (5) In March 2000, the Centers for Disease Control and Prevention estimated that more than three hundred eighty thousand (380,000) percutaneous injuries from contaminated sharps occur annually among healthcare workers in United States hospital settings; (6) Estimates for all healthcare settings are that six hundred thousand (600,000) to eight hundred thousand (800,000) needlestick and other percutaneous injuries occur among healthcare workers annually involving sharps contaminated with blood-borne pathogens such as the human immunodeficiency virus (HIV), hepatitis B, or hepatitis C; (7) Since publication of the blood-borne pathogens standard in 1991, there has been a substantial increase in the number and assortment of effective engineering controls available to employers; (8) There is now a large body of research and data concerning the effectiveness of newer engineering controls, including safer medical devices; (9) Numerous studies have demonstrated that the use of safer medical devices such as needle-less systems and sharps with engineered sharps injury protections can be extremely effective in reducing accidental sharps injuries when they are part of an overall blood-borne pathogens risk-reduction program; (10) In March 2000, the Centers for Disease Control and Prevention estimated that sixty-two percent (62%) to eighty-eight percent (88%) of sharps injuries potentially can be prevented by the use of safer medical devices depending on the type of device used and the procedure involved; (11) Training and education in the use of safer medical devices and safer work practices are significant elements in the prevention of percutaneous exposure incidents; (12) Staff involvement in the device selection and evaluation process is also an important element in achieving a reduction in sharps injuries, particularly as newer, safer devices are introduced into work settings; (13) The United States Congress has recognized the seriousness of the dangers of sharps injuries by passing the Needlestick Safety and Prevention Act, Pub. L. No. 106-430; and (14) Considerable time will lapse before federal regulations are published, hospitals prepare implementation plans, federal agencies review implementation plans, and hospitals begin implementation. (b) As used in this section: (1) “High-risk area” means the emergency department, operating rooms, and intensive care units in acute care hospitals; (2) “Needleless systems” means devices that do not use needles for: (A) The collection of bodily fluids or withdrawal of bodily fluids after initial venous or arterial access is established; (B) The administration of medication or fluids; or (C) Any other procedure involving the potential for occupational exposure to blood-borne pathogens due to percutaneous injuries from contaminated sharps; (3) “Sharps” means a needle used to withdraw bodily fluids, access a vein or artery, or administer medication or other fluids; and (4) “Sharps with engineered sharps injury protections” means a nonneedle sharp or a needle device used for withdrawing bodily fluids, accessing a vein or artery, or administering medications or other fluids with a built-in safety feature or mechanism that effectively reduces the risk of an exposure incident. (c) Immediately after June 1, 2001, hospitals shall begin purchasing needleless systems or sharps with engineered sharps injury protections, or both, for use in high-risk areas, with the goal of ensuring that within eighteen (18) months after June 1, 2001, all high-risk areas shall be supplied exclusively with needleless systems or sharps with engineered sharps injury protections, or both. (d) Any prefilled syringe approved by the United States Food and Drug Administration shall not be subject to the provisions of this section until July 2005.

Ark. Code Ann. § 20-9-314 Hospital pricing transparency — Legislative findings.

(a) The General Assembly finds that: (1) Under 45 C.F.R. Part 180, each hospital operating in the United States is required to provide clear, accessible pricing information online about the items and services that the hospital provides; and (2) Easy-to-understand pricing information is essential to support patients, prevent fraud, and protect consumers from unfair medical bills. (b)(1) A hospital licensed in this state shall comply with 45 C.F.R. (2) If the Department of Health finds that a hospital licensed in this state has not complied with 45 C.F.R. Part 180, as existing on January 1, 2023, then the department shall fine the hospital two hundred fifty dollars ($250) per day for noncompliance.

Ark. Code Ann. § 20-9-401 Definitions.

As used in this subchapter: (1) “Freestanding birthing center” means any facility, institution, or place, which is not an ambulatory surgical center or a hospital or in a hospital, organized to provide family-centered maternity care for women and childbearing families in which births are planned to occur in a homelike atmosphere away from the mothers' usual residences following a low-risk pregnancy; and (2) “Low-risk pregnancy” means a normal uncomplicated pregnancy as determined by a generally accepted course of prenatal care and expectation of a normal uncomplicated birth as defined by reasonable and generally accepted criteria of maternal and fetal health.

Ark. Code Ann. § 20-9-402 Deliveries — Dismissal of mother and infant.

(a) A freestanding birthing center shall have a qualified medical director, and deliveries shall be performed by a qualified physician or by a certified nurse midwife in accordance with an arrangement with a physician as required by § 17-87-101 et seq. (b) A mother and her infant shall be dismissed from a freestanding birthing center within twenty-four (24) hours of the admission.

Ark. Code Ann. § 20-9-403 Regulation by Department of Health.

(a) The Department of Health shall establish and enforce rules: (1) Setting minimum standards for the construction, maintenance, and operation of a freestanding birthing center; and (2) Setting qualifications for medical directors of freestanding birthing centers and for physicians who will perform deliveries in freestanding birthing centers. (b) A freestanding birthing center shall meet life safety code and construction standards developed by the National Fire Protection Association and shall comply with rules developed by the department.

Ark. Code Ann. § 20-9-404 License fee.

The Department of Health may levy and collect a fee for the issuance of an annual license to a freestanding birthing center. The license fee for a freestanding birthing center shall be an annual fee of one thousand dollars ($1,000).

Ark. Code Ann. § 20-9-405 Practice of midwifery.

Nothing in this subchapter shall be construed to prohibit the lawful practice of lay midwifery in any location under the Licensed Lay Midwife Act, § 17-85-101 et seq.

Ark. Code Ann. § 20-9-501 Definition.

As used in this subchapter, “peer review committee” or “committee” means a committee of a hospital medical staff, a committee of a state or local professional association, or a committee organized by and operating pursuant to a written plan or policy under the auspices of a professional corporation or a professional limited liability company whose members are licensed to practice medicine in this state that is formed to: (1) Evaluate and improve the quality of health care rendered by providers of health services; or (2) Determine that: (A) Health services rendered were professionally indicated or were performed in compliance with the applicable standard of care; or (B) The cost of health care rendered was considered reasonable by the providers of professional health services in the area.

Ark. Code Ann. § 20-9-502 Liability of committee members.

(a) There shall be no monetary liability on the part of, and no cause of action for damages shall arise against, any member of a peer review committee for any act or proceeding undertaken or performed within the scope of the functions of the committee if the committee member acts without malice or fraud. (b) This subchapter shall not be construed to confer immunity from liability on any professional association or upon any health professional while performing services other than as a member of a peer review committee.

Ark. Code Ann. § 20-9-503 Proceeding and records confidential — Exception.

(a)(1) The proceedings and records of a peer review committee shall not be subject to discovery or introduction into evidence in any civil action against a provider of professional health services arising out of the matters which are subject to evaluation and review by the committee. (2) No person who was in attendance at a meeting of the committee shall be permitted or required to testify in any such civil action as to any evidence or other matters produced or presented during the proceedings of the committee or as to any findings, recommendations, evaluations, opinions, or other actions of the committee or any members thereof. (b)(1) However, information, documents, or records otherwise available from original sources are not to be construed as immune from discovery or use in any such action merely because they were presented during the proceedings of the committee. (2) Nor shall any person who testifies before the committee or who is a member of the committee be prevented from testifying as to matters within his or her knowledge, but the witness shall not be asked about his or her testimony before the committee or about opinions formed by him or her as a result of the committee hearings. (c) The submission of the peer review proceedings, minutes, records, reports, and communications to a hospital governing board or physician group peer review committee as defined under § 20-9-501 shall not operate as a waiver of the privilege.

Ark. Code Ann. § 20-9-601 Definition.

(a) As used in this subchapter, “of unsound mind” means the inability to perceive all relevant facts related to one's condition and proposed treatment so as to make an intelligent decision based thereon, whether or not the inability is: (1) Only temporary, has existed for an extended period of time, or occurs or has occurred only intermittently; or (2) Due to natural state, age, shock or anxiety, illness, injury, drugs or sedation, intoxication, or other cause of whatever nature. (b) An individual shall not be considered to be of unsound mind based solely upon his or her refusal of medical care or treatment.

Ark. Code Ann. § 20-9-602 Consent generally — Definition.

It is recognized and established that, in addition to other authorized persons, any one (1) of the following persons may consent, either orally or otherwise, to any surgical or medical treatment or procedure not prohibited by law that is suggested, recommended, prescribed, or directed by a licensed physician: (1) Any adult, for himself or herself; (2)(A) Any parent, whether an adult or a minor, for his or her minor child or for his or her adult child of unsound mind, whether the child is of the parent's blood, an adopted child, a stepchild, a foster child not in custody of the Department of Human Services, or a preadoptive child not in custody of the department. (B) However, the father of an illegitimate child cannot consent for the child solely on the basis of parenthood; (3) Any married person, whether an adult or a minor, for himself or herself; (4) Any female, regardless of age or marital status, for herself when given in connection with pregnancy or childbirth, except the unnatural interruption of a pregnancy; (5) Any person standing in loco parentis, whether formally serving or not, and any guardian, conservator, or custodian, for his or her ward or other charge under disability; (6) Any emancipated minor, for himself or herself; (7) Any unemancipated minor of sufficient intelligence to understand and appreciate the consequences of the proposed surgical or medical treatment or procedures, for himself or herself; (8) Any adult, for his or her minor sibling or his or her adult sibling of unsound mind; (9) During the absence of a parent so authorized and empowered, any maternal grandparent and, if the father is so authorized and empowered, any paternal grandparent, for his or her minor grandchild or for his or her adult grandchild of unsound mind; (10) Any married person, for a spouse of unsound mind; (11) Any adult child, for his or her mother or father of unsound mind; (12) Any minor incarcerated in the Division of Correction or the Division of Community Correction, for himself or herself; (13)(A) Any foster parent or preadoptive parent, for a child in custody of the department in: (i)(a) Emergency situations. (b) As used in this subdivision (13)(A)(i), “emergency situation” means a situation in which, in competent medical judgment, the proposed surgical or medical treatment or procedures are immediately or imminently necessary and any delay occasioned by an attempt to obtain consent would reasonably be expected to jeopardize the life, health, or safety of the person affected or would reasonably be expected to result in disfigurement or impaired faculties; (ii) Routine medical treatment; (iii) Ongoing medical treatment; (iv) Nonsurgical procedures by a primary care provider; and (v) Nonsurgical procedures by a specialty care provider. (B) The department shall be given timely notice of all admissions and discharges consented to by a foster parent or preadoptive parent for a child in custody of the department. (C) The consent of a representative of the department is required for: (i) Nonemergency surgical procedures; (ii) Nonemergency invasive procedures; (iii) “End-of-life” nonemergency procedures, such as do-not-resuscitate orders, withdrawal of life support, and organ donation; and (iv) Nonemergency medical procedures relating to a criminal investigation or judicial proceeding that involves gathering forensic evidence; and (14) A local educational agency liaison for homeless children and youths under the federal McKinney-Vento Homeless Assistance Act, 42 U.S.C. § 11432 et seq., as existing on January 1, 2019, when the minor patient: (A) Meets the definition of a homeless child or youth under the federal McKinney-Vento Homeless Assistance Act, 42 U.S.C. § 11432 et seq., as existing on January 1, 2019; (B) Is not in the care or custody of a parent or guardian; and (C) Is not in the care or custody of the department.

Ark. Code Ann. § 20-9-603 Implied consent — Definition.

In addition to any other instances in which consent is excused or implied at law, consent to surgical or medical treatment or procedures suggested, recommended, prescribed, or directed by a licensed physician will be implied in the following circumstances: (1)(A) When an emergency exists and there is no one immediately available who is authorized, empowered to, or capable of consent. (B) “Emergency” means a situation in which, in competent medical judgment, the proposed surgical or medical treatment or procedures are immediately or imminently necessary and any delay occasioned by an attempt to obtain a consent would reasonably be expected to jeopardize the life, health, or safety of the person affected or would reasonably be expected to result in disfigurement or impaired faculties; and (2) When any emergency exists, there has been a protest or refusal of consent by a person authorized and empowered to do so, and there is no other person immediately available who is authorized, empowered, or capable of consenting but there has been a subsequent material and morbid change in the condition of the affected person.

Ark. Code Ann. § 20-9-604 Consent given by court in emergency.

(a)(1) Except as provided in subsection (e) of this section, consent may be given by a court when: (A) An emergency exists; (B) There has been a protest or refusal of consent by a person authorized and empowered to do so; and (C) There is no other person immediately available who is authorized, empowered, or capable of consent. (2) The consent shall be given upon the presentation of a petition accompanied by the written advice or certificate of one (1) or more licensed physicians that in their professional opinion there is an immediate or imminent necessity for medical or surgical treatment or procedures. (3) Any circuit judge may summarily grant injunctive and declaratory relief ordering and directing that the necessary surgical or medical treatment or procedures be rendered, provided that the affected person is: (A) A pregnant female in the last trimester of pregnancy; (B) A person of insufficient age or mental capacity to understand and appreciate the nature of the proposed surgical or medical treatment and the probable consequences of refusal of the treatment; or (C) A parent of a minor child, provided that the court in its discretion finds that the life or health of the parent is essential to the child's financial support or physical or emotional well-being. (b) Any circuit judge granting the declaratory and injunctive relief directing the provision of surgical or medical treatment or procedures pursuant to this section shall be immune from liability based on any claim that the surgical or medical treatment or procedures for the affected person should not have been administered. (c) The reasonable expense incurred for emergency surgical or medical treatment or procedures administered pursuant to this section shall be borne by: (1) The estate of the person affected; (2) Any person liable at law for the necessities of the person affected; or (3) If the estate or person is unable to pay, the county of residence of the person receiving the surgical or medical care. (d) Upon request of an attending physician, any other licensed physician, or a representative of a hospital to which a patient has been admitted or presented for treatment, it shall be the duty of the prosecuting attorney, or his or her designee, of the county in which the surgical or medical care is proposed to be rendered to give his or her assistance in the presentation of the petition, with medical advice or certificate, and in obtaining an order from the court of proper jurisdiction. (e)(1) Consent may be given by a court when an emergency exists and there is no one immediately available who is authorized, empowered to, or capable of consent for a person of unsound mind or there has been a subsequent material and morbid change in the condition of the affected person who is in the custody of the Division of Correction or the Division of Community Correction. (2) The consent shall be given upon the presentation of a petition accompanied by the written advice or certificate of one (1) or more licensed physicians that in their professional opinion there is an immediate or imminent necessity for medical or surgical treatment or procedures. (3) Any circuit judge may summarily grant injunctive and declaratory relief ordering and directing that the necessary surgical or medical treatment or procedures be rendered.

Ark. Code Ann. § 20-9-701 Uniform Medicare charges.

The agency administering the Medicare program in Arkansas shall establish reasonable charges on a single statewide basis according to field of practice. The reasonable charges shall be based on uniform prevailing limits for all physicians throughout the state for the same or similar services.

Ark. Code Ann. § 20-9-702 Immunity of hospital utilization review committees.

(a) Physicians and others appointed to hospital utilization review committees for the purpose of determining questions relating to the hospitalization of Medicare patients under the Health Insurance for the Aged and Disabled Act, 42 U.S.C. § 1395 et seq., shall be immune from liability with respect to decisions made as to such questions as long as the physicians or others act in good faith and without malice. (b) However, nothing in this section shall be construed to relieve any patient's personal physician of any liability which he or she may have in connection with the treatment of the patient.

Ark. Code Ann. § 20-9-801 Declaration of policy.

(a) The availability of scientific knowledge, skills, and materials for the transplantation, injection, transfusion, or transfer of human tissue, organs, blood, and components thereof is important to the health and welfare of the people of this state. (b) The imposition of legal liability without fault upon the persons and organizations engaged in such scientific procedures inhibits the exercise of sound medical judgment and restricts the availability of important scientific knowledge, skills, and materials. (c) It is therefore the public policy of this state to promote the health and welfare of the people by limiting the legal liability arising out of such scientific procedures to instances of negligence or willful misconduct.

Ark. Code Ann. § 20-9-802 Limitation of liability.

No physician, surgeon, hospital, blood bank, tissue bank, or other person or entity who donates, obtains, prepares, transplants, injects, transfuses, or otherwise transfers or who assists or participates in obtaining, preparing, transplanting, injecting, transfusing, or transferring any tissue, organ, blood, or component thereof from one (1) or more human beings, living or dead, to another human being, shall be liable as the result of the activity, except that each such person or entity shall remain liable for negligence or willful misconduct only.

Ark. Code Ann. § 20-9-901 Purpose.

The purpose of this subchapter is to: (1) Promote the delivery of quality health care in a cost-effective manner; (2) Foster greater coordination between payors and providers conducting utilization review activities; (3) Protect patients, business, and providers by ensuring that private review agents are qualified to perform utilization activities and to make informed decisions on the appropriateness of medical care; and (4) Ensure that private review agents maintain the confidentiality of medical records.

Ark. Code Ann. § 20-9-902 Definitions.

As used in this subchapter: (1) [Repealed.] (2) “Certificate” means a certificate of registration granted by the State Board of Health to a private review agent; (3)(A) “Private review agent” means a nonhospital-affiliated person or entity performing utilization review on behalf of: (i) An employer of employees in the State of Arkansas; or (ii) A third party that provides or administers hospital and medical benefits to citizens of this state, including: (a) A health maintenance organization issued a certificate of authority under and by virtue of the laws of the State of Arkansas; and (b) A health insurer, nonprofit health service plan, health insurance service organization, or preferred provider organization or other entity offering health insurance policies, contracts, or benefits in this state. (B) “Private review agent” does not include automobile, homeowner, or casualty and commercial liability insurers or their employees, agents, or contractors; (4) “Utilization review” means a system for review which reviews the appropriate and efficient allocation of hospital resources and medical services given or proposed to be given to a patient or group of patients; and (5) “Utilization review plan” means a description of the utilization review procedures of a private review agent.

Ark. Code Ann. § 20-9-903 Certificate required.

A private review agent who approves or denies payment or who recommends approval or denial of payment for hospital or medical services or whose review results in approval or denial of payment for hospital or medical services on a case-by-case basis may not conduct utilization review in this state unless the State Board of Health has granted the private review agent a certificate.

Ark. Code Ann. § 20-9-904 When certificate not required.

(a) The State Board of Health may waive the requirements of this subchapter for the activities of a private review agent in connection with a contract with the United States Government for utilization review of patients eligible for hospital and medical services under the Social Security Act. (b) No certificate is required for those private review agents conducting general in-house utilization review for hospitals, home health agencies, preferred provider organizations, other managed care entities, clinics, private offices, or any other health facilities or entities, so long as the review does not result in the approval or denial of payment for hospital or medical services for a particular case. The general in-house utilization review is exempt from this subchapter. (c) No certificate is required for utilization review by any Arkansas-licensed pharmacist or pharmacy, or organizations of either, while engaged in the practice of pharmacy, including, but not limited to, dispensing of drugs, participation in drug utilization reviews, and monitoring patient drug therapy.

Ark. Code Ann. § 20-9-905 Penalty.

(a) A person who violates any provision of this subchapter or any rule adopted under this subchapter shall be guilty of a violation and upon conviction shall be subject to a penalty not exceeding one thousand dollars ($1,000). (b) Each day that a violation is continued after the first conviction is a separate offense.

Ark. Code Ann. § 20-9-906 Duties of State Board of Health.

(a)(1) In accordance with the Arkansas Administrative Procedure Act, § 25-15-201 et seq., the State Board of Health shall adopt rules to implement this subchapter. (2) Rules governing utilization review plans under this subchapter shall impose no greater requirements than those required for utilization review activities for state-certified health maintenance organizations under the laws of this state, as amended from time to time. (3) Any information required by the board with respect to customers, patients, or utilization review procedures of a private review agent shall be held in confidence and not disclosed to the public. (b) The board shall issue a certificate to an applicant that has met all the requirements of this subchapter and all applicable rules of the board. (c) The board may establish reporting requirements to: (1) Evaluate the effectiveness of private review agents; and (2) Determine if the utilization review programs are in compliance with this subchapter and applicable rules. (d) A certificate issued under this subchapter is not transferrable.

Ark. Code Ann. § 20-9-907 Health insurance plans — Insurers.

(a)(1) Every health insurance plan proposing to issue or deliver a health insurance policy or contract or administer a health benefit program which provides for the coverage of hospital and medical benefits and the utilization review of those benefits shall: (A) Have a certificate in accordance with this subchapter; or (B) Contract with a private review agent who has a certificate in accordance with this subchapter. (2) Notwithstanding any other provisions of this subchapter, for claims in which the medical necessity of the provision of a covered benefit is disputed, a health service plan that does not meet the requirements of this subsection shall pay any person or hospital entitled to reimbursement under the policy or contract. (b)(1) Every insurer proposing to issue or deliver a health insurance policy or contract or administer a health benefit program which provides for the coverage of hospital and medical benefits and the utilization review of such benefits shall: (A) Have a certificate in accordance with this subchapter; or (B) Contract with a private review agent that has a certificate in accordance with this subchapter. (2) Notwithstanding any provision of this subchapter, for claims in which the medical necessity of the provision of a covered benefit is disputed, an insurer that does not meet the requirements of this subsection shall pay any person or hospital entitled to reimbursement under the policy or contract. (c)(1) Any health insurer proposing to issue or deliver in this state a group or blanket health insurance policy or administer a health benefit program which provides for the coverage of hospital and medical benefits and the utilization review of such benefits shall: (A) Have a certificate in accordance with this subchapter; or (B) Contract with a private review agent that has a certificate in accordance with this subchapter. (2) Notwithstanding any provision of this subchapter, for claims in which the medical necessity of the provision of a covered benefit is disputed, a health insurer that does not meet the requirements of this subsection shall pay any person or hospital entitled to reimbursement under the policy or contract.

Ark. Code Ann. § 20-9-908 Application for certification — Fee.

(a) An applicant for a certificate shall: (1) Submit an application to the State Board of Health; and (2) Pay to the board the application fee established by the board by rule. (b) The application shall: (1) Be on a form and accompanied by any supporting documentation that the board requires; and (2) Be signed and verified by the applicant. (c) The application fee required under this section shall be sufficient to pay for the administrative cost of the certification program and any other cost associated with carrying out this subchapter. (d)(1) All application fees shall be special revenues and deposited to the credit of the Public Health Fund. (2) Any unexpended balance of such fees at the end of each state fiscal year shall be carried forward to the next fiscal year to be used for the same intent and purposes as set forth in this subchapter.

Ark. Code Ann. § 20-9-909 Information required with application.

In conjunction with the application, the private review agent shall submit information that the State Board of Health requires, including: (1) A utilization review plan that includes: (A) A description of review standards and procedures to be used in evaluating proposed or delivered hospital and medical care; and (B) The provisions by which patients, physicians, or hospitals may seek reconsideration or appeal of adverse decisions by the private review agent; (2) The type and qualifications of the personnel either employed or under contract to perform the utilization review; (3) The procedures and policies to ensure that a representative of the private review agent is reasonably accessible to patients and providers five (5) days a week during normal business hours in this state; (4) The policies and procedures to ensure that all applicable state and federal laws to protect the confidentiality of individual medical records are followed; (5) A copy of the materials designed to inform applicable patients and providers of the requirements of the utilization review plan; and (6) A list of the third party payors for which the private review agent is performing utilization review in this state.

Ark. Code Ann. § 20-9-910 Expiration of certificate — Renewal.

(a) A certificate expires on the second anniversary of its effective date unless the certificate is renewed for a two-year term as provided in this section. (b) Before the certificate expires, a certificate may be renewed for an additional two-year term if the applicant: (1) Otherwise is entitled to the certificate; (2) Pays the State Board of Health the renewal fee set by the board by rule; and (3) Submits to the board: (A) A renewal application on the form that the board requires; and (B) Satisfactory evidence of compliance with any requirement of this subchapter for certificate renewal.

Ark. Code Ann. § 20-9-911 Revocation or denial of certificate.

(a) The State Board of Health may revoke or deny a certificate if the holder does not comply with performance assurances under this section, violates any provision of this subchapter, or violates any rule adopted pursuant to this subchapter. (b) The board shall deny a certificate to any applicant if upon review of the application the board finds that the applicant proposing to conduct a utilization review does not: (1) Have available the services of a sufficient number of qualified medical professionals supported and supervised by appropriate physicians to carry out its utilization review activities; (2) Meet any applicable rules the board adopted under this subchapter relating to the qualifications of private review agents or the performance of utilization review; and (3) Provide assurances satisfactory to the board that: (A) The procedure and policies of the private review agent will protect the confidentiality of medical records; and (B) The review agent will be reasonably accessible to patients and providers for five (5) working days a week during normal business hours in this state.

Ark. Code Ann. § 20-9-912 Appeals.

(a)(1) Before denying or revoking a certificate under this subchapter, the State Board of Health shall provide the applicant or certificate holder with reasonable time to supply additional information demonstrating compliance with the requirements of this subchapter and the opportunity to request a hearing. (2) If an applicant or certificate holder requests a hearing, the board shall send a hearing notice and conduct a hearing in accordance with the Arkansas Administrative Procedure Act, § 25-15-201 et seq. (b) Any person aggrieved by a final decision of the board in a contested case under this subchapter may take a direct judicial appeal as provided for in the Arkansas Administrative Procedure Act, § 25-15-201 et seq.

Ark. Code Ann. § 20-9-913 Confidentiality.

A private review agent may not disclose or publish individual medical records or any other confidential medical information obtained in the performance of utilization review activities without the appropriate procedures for protecting the patient's confidentiality. However, nothing in this subchapter shall prohibit private review agents from providing patient information to a third party whom the private review agent is affiliated with, under contract with, or acting on behalf of.

Ark. Code Ann. § 20-9-914 Liability unaffected.

Nothing in this subchapter shall be deemed to reduce or expand the liability of any person or entity for any actions or activities with respect to utilization review.

Ark. Code Ann. § 20-9-1001 Title.

This subchapter shall be known and may be cited as the “Acute Stroke Care Act of 2005”.

Ark. Code Ann. § 20-9-1002 Findings.

The General Assembly finds that: (1) The citizens of the State of Arkansas are entitled to the maximum protection which is practicable from the effects of strokes; (2) Each year about seven hundred thousand (700,000) Americans experience a new or recurrent stroke; (3) On average, a stroke strikes someone every forty-five (45) seconds, and someone dies of a stroke every three and one-tenth (3.1) minutes; (4) Stroke is the leading cause of serious, long-term disability in the United States, with about four million seven hundred thousand (4,700,000) stroke survivors alive today; (5) Stroke is the third leading cause of death in the United States, causing fifty-seven and seven-tenths (57.7) deaths per one hundred thousand (100,000) population; and (6) In Arkansas, the death rate from stroke is seventy-five and nine-tenths (75.9) per one hundred thousand (100,000), the highest in the nation.

Ark. Code Ann. § 20-9-1003 Acute Stroke Care Task Force — Creation.

(a) There is created the Acute Stroke Care Task Force to consist of twelve (12) members. (b) The Secretary of the Department of Health shall appoint: (1) One (1) member to represent the Department of Health; (2) One (1) member to represent the American Heart Association and the American Stroke Association; (3) One (1) member to represent the Arkansas Minority Health Commission; (4) One (1) member to represent the Arkansas Hospital Association, Inc.; (5) One (1) member to represent the Arkansas Foundation for Medical Care, Inc.; (6) One (1) member to represent the Fay W. Boozman College of Public Health of the University of Arkansas for Medical Sciences; (7) One (1) member to represent the Division of Medical Services; (8) One (1) member to represent emergency medical services; (9) One (1) member to represent the Arkansas Medical Society, Inc.; (10) One (1) member to represent the medical insurance industry; (11) One (1) member to represent the community at large; and (12) One (1) member to represent the Arkansas Medical, Dental, and Pharmaceutical Association, Inc. (c)(1) Except for the initial members, task force members shall serve three-year terms. (2) The initial members shall be assigned by lot so as to stagger terms to equalize as nearly as possible the number of members to be appointed each year. (d) If a vacancy occurs, the secretary shall appoint a person who represents the same constituency as the member being replaced. (e) The task force shall elect one (1) of its members to act as chair for a term of one (1) year. (f) A majority of the members shall constitute a quorum for the transaction of business. (g) The task force shall meet as necessary to further the intent and purpose of this subchapter. (h) The Department of Health shall provide office space and staff for the task force. (i) Members of the task force shall serve without pay but may receive expense reimbursement in accordance with § 25-16-902 if funds are available.

Ark. Code Ann. § 20-9-1004 Powers and duties.

The Acute Stroke Care Task Force shall: (1) Make recommendations to the State Board of Health consistent with the intent and purpose of this subchapter; (2) Pursue both public and private funding to further the intent of this subchapter; and (3) Develop standards and policy recommendations considering, but not limited to, the following: (A) Methods for raising public awareness of the prevalence and treatment considerations for strokes; (B) The professional development of emergency medical services professionals to identify victims of potential stroke; (C) The professional development of emergency room and hospital personnel to identify and treat victims of potential stroke; (D) Methods for encouraging the use of thrombolytics, clot-busting drugs, or other accepted or emerging treatments, when appropriate; (E) Methods for ensuring that a comprehensive range of stroke recovery services are available to Arkansans as they recover physical and mental functions affected by a stroke; (F) Methods for developing stroke treatment centers; and (G) Methods for developing a stroke registry for Arkansas.

Ark. Code Ann. § 20-9-1005 State Board of Health — Powers and duties.

The State Board of Health, after consultation with the Acute Stroke Care Task Force and if funds are available, may promulgate rules to further the intent of this subchapter.

Ark. Code Ann. § 20-9-1101 Title.

This subchapter shall be known as the “Cervical Cancer Care Act of 2005”.

Ark. Code Ann. § 20-9-1102 Cervical Cancer Task Force — Creation.

(a) There is created the Cervical Cancer Task Force to consist of twelve (12) members. (b) The Secretary of the Department of Health shall appoint: (1) One (1) member to represent the Department of Health; (2) One (1) member to represent the American Cancer Society; (3) One (1) member to represent the Arkansas Minority Health Commission; (4) One (1) member to represent the Arkansas Hospital Association, Inc.; (5) One (1) member to represent the Arkansas Foundation for Medical Care, Inc.; (6) One (1) member to represent the Fay W. Boozman College of Public Health of the University of Arkansas for Medical Sciences; (7) One (1) member to represent the Division of Medical Services; (8) One (1) member to represent primary care physicians; (9) One (1) member to represent the Arkansas Medical Society, Inc.; (10) One (1) member to represent the medical insurance industry; (11) One (1) member to represent the community at large; and (12) One (1) member to represent the Arkansas Medical, Dental, and Pharmaceutical Association, Inc. (c)(1) Except for the initial members, task force members shall serve three-year terms. (2) The initial members shall be assigned by lot so as to stagger terms to equalize as nearly as possible the number of members to be appointed each year. (d) If a vacancy occurs, the secretary shall appoint a person who represents the same constituency as the member being replaced. (e) The task force shall elect one (1) of its members to act as chair for a term of one (1) year. (f) A majority of the members shall constitute a quorum for the transaction of business. (g) The task force shall meet as necessary to further the intent and purpose of this subchapter. (h) The Department of Health shall provide meeting space and administrative support for the task force. (i) Members of the task force shall serve without pay but may receive expense reimbursement in accordance with § 25-16-902 if funds are available.

Ark. Code Ann. § 20-9-1103 Cervical Cancer Task Force — Powers and duties.

(a) The Cervical Cancer Task Force shall: (1) Make recommendations to the Breast Cancer Control Advisory Board consistent with the intent of this subchapter; (2) Pursue both public and private funding to further the intent of this subchapter; and (3) Develop standards and policy recommendations considering, but not limited to, the following: (A) Methods for raising public awareness of the prevalence, causes, prevention, screening, and treatment considerations for cervical cancer; (B) Methods for raising the medical community's awareness of the prevalence, causes, prevention, screening, and treatment considerations for cervical cancer; and (C) Methods for ensuring that services across the spectrum of causes, prevention, screening, evaluation, and treatment are available to women in Arkansas. (b) The Arkansas Central Cancer Registry of the Department of Health shall provide an annual cervical cancer report to the task force.

Ark. Code Ann. § 20-9-1104 State Board of Health — Powers and duties.

After consultation with the Cervical Cancer Task Force and if funds are available, the State Board of Health may promulgate rules to further the intent of this subchapter.

Ark. Code Ann. § 20-9-1201 Title.

This subchapter shall be known and may be cited as the “Health Facility Infection Disclosure Act of 2007”.

Ark. Code Ann. § 20-9-1202 Definitions.

As used in this subchapter: (1)(A) “Health facility” means any of the following facilities: (i) A hospital, outpatient surgery center, public health center, or recuperation center, as those facilities are defined in § 20-9-201; and (ii) Any other facility determined to be a source of healthcare-associated infections and designated as such by the Department of Health. (B) “Health facility” does not include: (i) A physician's office unless the office is otherwise licensed as an outpatient surgery center; or (ii) An establishment furnishing primarily domiciliary care; (2) “Healthcare-associated infection” means a localized or systemic condition in a person that: (A) Results from adverse reaction to the presence of an infectious agent or a toxin of an infectious agent; and (B) Was not present or incubating in the person at the time of admission to the health facility; and (3) “National Healthcare Safety Network” means the secure, internet-based surveillance system managed by the Division of Healthcare Quality Promotion at the Centers for Disease Control and Prevention created by the Centers for Disease Control and Prevention for accumulating, exchanging, and integrating relevant information on infectious adverse events associated with healthcare delivery.

Ark. Code Ann. § 20-9-1203 Health facility reports.

(a) A health facility shall collect data on healthcare-associated infection rates for the following: (1) Central line-associated bloodstream infections in an intensive care unit; and (2) Other categories as provided under § 20-9-1204(e). (b)(1)(A) A health facility may voluntarily submit quarterly reports to the Department of Health on the health facility's healthcare-associated infection rates. (B)(i) If a health facility elects to submit quarterly reports, the reports shall be submitted to the department: (a) In a format prescribed by the department; and (b) By April 30, July 31, October 31, and January 31 of each year. (ii) Each quarterly report shall cover the immediately preceding calendar quarter. (C) Data in the quarterly reports shall cover a period ending not earlier than one (1) month before the submission of the report. (2) If the health facility is a division or subsidiary of another entity that owns or operates other health facilities, the quarterly report shall be for the specific division or subsidiary and not for the other entity. (c)(1) A health facility participating in the Centers for Medicare & Medicaid Services Hospital Inpatient Quality Reporting Program or its successor shall authorize the department to have access to the following information that the health facility submits to the National Healthcare Safety Network: (A) The name of the health facility; and (B) Any information submitted to the National Healthcare Safety Network in order to satisfy the requirements of the Centers for Medicare & Medicaid Services Hospital Inpatient Quality Reporting Program. (2) The information contained in the National Healthcare Safety Network database and obtained by the department under this section may be used by the department for surveillance and prevention purposes only and shall not be used for regulatory purposes.

Ark. Code Ann. § 20-9-1204 Advisory Committee on Healthcare Acquired Infections.

(a) The Secretary of the Department of Health shall appoint an Advisory Committee on Healthcare Acquired Infections, including without limitation representatives of: (1) Public and private hospitals, including representatives of hospitals with fewer than fifty (50) beds and representatives of hospitals with more than fifty (50) beds; (2) Outpatient surgery centers; (3) Direct-care nursing staff; (4) Physicians; (5) Infection-control professionals with expertise in healthcare-associated infections; (6) Academic researchers; and (7) At least one (1) representative of a consumer organization. (b) The committee shall assist the Department of Health in the development of all aspects of the department's methodology for collecting, analyzing, and disclosing the data collected under this subchapter, including without limitation: (1) Collection methods; (2) Formatting; and (3) Methods and means for the release and dissemination of the data. (c)(1) In developing the methodology for collecting and analyzing the infection-rate data, the department and the committee shall consider existing methodologies and systems for data collection. (2) Any data collection and analytical methodologies used shall be: (A) Capable of being validated; and (B) Based upon nationally recognized and recommended standards that may include those developed by the Centers for Disease Control and Prevention, the Centers for Medicare & Medicaid Services, the United States Agency for Healthcare Research and Quality, or the National Quality Forum. (3) The proposed data collection and analysis methodology shall be disclosed for public comment before any public disclosure of healthcare-associated infection rates in an annual report under § 20-9-1205. (4)(A) The data collection and analysis methodology shall be presented to all health facilities in this state on or before September 1, 2008. (B) The methodology may be amended based upon input from the health facilities. (5)(A) The first voluntary quarterly report under § 20-9-1203(b) shall be presented to the department on or before January 31, 2009. (B) Health facilities may begin voluntarily reporting data on January 31, 2009, or at any time thereafter. (d) The department and the committee shall evaluate on a regular basis the quality and accuracy of health facility data reported under this subchapter and the data collection, analysis, and dissemination methodologies used under this subchapter. (e) After release of the second annual report published under § 20-9-1205 and upon consultation with the committee and with other technical advisors who are recognized experts in the prevention, identification, and control of healthcare-associated infections and the reporting of performance data, the department may add categories of infections to those set forth in § 20-9-1203(a) in compliance with the Arkansas Administrative Procedure Act, § 25-15-201 et seq.

Ark. Code Ann. § 20-9-1205 Reports regarding healthcare-associated infections.

(a)(1)(A) In consultation with the Advisory Committee on Healthcare Acquired Infections, the Department of Health shall submit annually a report summarizing the health facility quarterly reports required under this subchapter to the Chair of the House Committee on Public Health, Welfare, and Labor and the Chair of the Senate Committee on Public Health, Welfare, and Labor. (B) No health-facility-identifiable data shall be included in the annual report, but aggregate statistical data may be included. (2) The department shall publish the annual report on the department's website. (3) The first annual report shall be submitted and published on or before January 1, 2010. (b) The annual report prepared by the department under this subchapter regarding healthcare-associated infections shall be appropriately risk-adjusted. (c) The annual report shall include an executive summary written in plain language that shall include without limitation: (1) A discussion of findings, conclusions, and trends concerning the overall status of healthcare-associated infections in the state, including a comparison to previous years; and (2) Policy recommendations of the department and the committee. (d) The annual report shall be made available to any person upon request. (e) No health facility report or department disclosure shall contain information identifying a patient, employee, or healthcare professional in connection with a specific infection incident. (f) No annual report or other department disclosure shall contain information that identifies or could be used to identify a specific health facility. (g)(1) As part of the process of preparing the annual report, effective safeguards to protect against the dissemination of inconsistent, incomplete, invalid, inaccurate, or subjective health facility data shall be developed and implemented. (2) These safeguards may include the exclusion of certain data or data from health facilities with a low volume of patients or procedures if the use of the data would skew the results reported. (h) The department shall develop, with the assistance of the committee, a process of regular and confidential feedback for health facilities regarding the data collected so that each health facility's data will be available to that health facility for its quality improvement efforts.

Ark. Code Ann. § 20-9-1206 Legislative intent — Privacy and confidentiality.

(a) It is the intent of the General Assembly that a patient's right of confidentiality shall not be violated in any manner under this subchapter. (b) Social Security numbers and any other information that could be used to identify an individual patient shall not be released under this subchapter. (c) Except for the annual report that shall be a public document available to any person upon request, any data and materials collected or compiled by a health facility or obtained by the Department of Health under this subchapter shall be exempt from discovery and disclosure to the same extent that records of and testimony before committees evaluating quality of medical or hospital care are exempt under § 16-46-105(a)(1) and shall not be admissible in any legal proceeding. (d) Data collected and reported under this subchapter shall not be deemed to have established a standard of care for any purposes in a private civil litigation.

Ark. Code Ann. § 20-9-1207 Rules.

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

Ark. Code Ann. § 20-9-1208 Funding.

This subchapter is contingent upon the appropriation and availability of funding necessary for the Department of Health to implement its provisions, and any requirements that actions be accomplished by a specific date shall be extended until the necessary funding is available.

Ark. Code Ann. § 20-9-1301 Title.

This subchapter shall be known and may be cited as the “Arkansas Peer Review Fairness Act”.

Ark. Code Ann. § 20-9-1302 Findings and intent.

(a) The General Assembly finds that: (1) The peer review process is well established as an acceptable means of monitoring quality and improving care within an institution; (2)(A) The peer review process faces unique challenges in the hospital setting compared to other healthcare settings due to the interdependent relationship between the hospital and medical staff, which can impact professional review activities. (B) Peer review that is not conducted fairly results in harm to both patients and physicians by limiting access to care and patient choice; and (3) It is necessary to balance carefully the rights of patients who benefit by properly conducted peer review with the rights of those who may be harmed by improper peer review. (b) The General Assembly intends that peer review be conducted fairly for the benefit of the citizens of the State of Arkansas.

Ark. Code Ann. § 20-9-1303 Definitions.

As used in this subchapter: (1) “Adversely affect”, when used in reference to clinical privileges or medical staff membership, means deny, reduce, restrict, suspend, revoke, or fail to renew; (2) “Conflict of interest” means a personal or financial interest that would lead an objective person to conclude that it would be difficult for the person in those circumstances to make a fair and impartial decision in a professional review activity with regard to a particular physician; (3) “Hospital” means a healthcare facility licensed as a hospital by the Division of Health Facilities Services under § 20-9-213; (4)(A) “Investigation” means a process conducted by a professional review body to: (i) Obtain and make a detailed examination of the facts related to an identified concern about a specific physician; and (ii) Determine whether a professional review action should be requested or recommended. (B) “Investigation” does not include the following: (i) A preliminary review to obtain basic information related to a concern or complaint about a physician in order to determine whether an investigation should commence; (ii) Routine quality assurance, case review, utilization review, and performance improvement activities that take place within a hospital; or (iii) Collegial interventions, ongoing physician practice evaluations and focused physician practice evaluations, and other peer-to-peer performance improvement interventions that are not intended to, and do not, impact a physician's clinical privileges or hospital medical staff membership; (5) “Medical staff” means the physicians who are approved and given privileges to provide health care to patients in the hospital; (6) “Professional review action” means an action or recommendation of a professional review body that is taken or made in the conduct of professional review activity and that: (A) Is based on an individual physician's competence or professional conduct that adversely affects or could adversely affect the health or welfare of a patient or patients; and (B) Adversely affects or may adversely affect the medical staff membership or clinical privileges of the physician; (7)(A) “Professional review activity” means an activity with respect to an individual physician: (i) To determine whether the physician may have clinical privileges at a hospital or membership on the hospital's medical staff; (ii) To determine the scope or conditions of clinical privileges or medical staff membership; or (iii) To change or modify such clinical privileges or medical staff membership. (B) “Professional review activity” includes an investigation, as defined in this section; and (8) “Professional review body” means a hospital, its governing body, or its medical staff when any of these bodies are conducting a professional review activity.

Ark. Code Ann. § 20-9-1304 Standards for professional review actions and professional review activities.

(a) Professional review activity shall be conducted and professional review actions shall be taken in compliance with the requirements of the Health Care Quality Improvement Act of 1986, 42 U.S.C. § 11101 et seq., and the additional requirements of this subchapter. (b)(1) If at any meeting or hearing held in the course of a professional review activity, an attorney is participating on behalf of a professional review body and the physician under review is present, then the physician under review shall be permitted to have the attorney of the physician present. (2) Subdivision (b)(1) of this section does not: (A) Entitle the attorney of the physician to appear at any meeting or hearing where an attorney participating on behalf of the peer review body is not present, except as provided in § 20-9-1310; (B) Prohibit confidential attorney-client communications by any party; or (C) Prohibit a professional review body from meeting in private with its attorney. (c) The General Assembly encourages: (1) Professional review bodies to use separate legal counsel from the legal counsel used by the hospital; and (2) Medical staff to obtain independent legal counsel to review medical staff bylaws to ensure that the bylaws contain provisions that comply with this subchapter. (d)(1) A physician engaged in professional review activities shall exercise unbiased, independent, and professional judgment when evaluating another physician. (2) A hospital shall not take action against or otherwise retaliate against a physician for exercising unbiased, independent, and professional judgment when evaluating another physician during the course of a professional review activity.

Ark. Code Ann. § 20-9-1306 Suspensions.

(a) If failure to take a professional review action may result in an imminent danger to the health of any individual, the hospital may immediately suspend or restrict the medical staff membership or clinical privileges of a physician. (b) If an action is taken under subsection (a) of this section, then the hospital shall follow all the other provisions of this subchapter as soon as practicable following the suspension or restriction. (c) In the case of a suspension or restriction of clinical privileges, for a period of not longer than fourteen (14) days, during which an investigation is being conducted to determine the need for a professional review action: (1) No hearing is required to be held regarding the suspension; (2) The parties shall comply with § 20-9-1309 and all other applicable provisions of this subchapter; and (3) The physician shall be given the opportunity to discuss the case with the individual or individuals conducting the investigation during the fourteen (14) days before any recommendation or decision is made about continuing the suspension or restriction.

Ark. Code Ann. § 20-9-1308 Relationship to other laws and regulations.

(a)(1) Except as provided in subsection (b) of this section, professional review activities are within the categories of records and proceedings that are exempt from discovery and disclosure under state law, including without limitation § 16-46-105(a)(1) and § 20-9-503. (2) This subchapter does not affect the admissibility in evidence in any action or proceeding of the medical records of any patient. (b) This subchapter does not: (1) Abrogate the immunity provisions of the Health Care Quality Improvement Act of 1986, 42 U.S.C. § 11101 et seq., or the confidentiality or immunity provisions of § 16-46-105, § 17-1-102, or § 20-9-501 et seq.; or (2) Prevent discovery and admissibility of evidence from the professional review activities if the legal action is brought by a physician who has been subjected to the professional review activity or action.

Ark. Code Ann. § 20-9-1309 Standards for investigations.

(a) A physician shall be informed in writing within five (5) business days of the date that the physician becomes a subject of an investigation. (b) Before a professional review body makes a recommendation as a result of an investigation, the physician under review shall be given an opportunity to have a meeting with the professional review body to discuss the matter without the presence of attorneys. (c)(1)(A) If the professional review body decides to use an external review during the investigation, physicians serving on the professional review body that is conducting the investigation are responsible for selecting any external reviewers and the method of selecting cases for review. (B) However, the physicians serving on the professional review body may seek input regarding the selection described under subdivision (c)(1)(A) of this section from the physician under review or other individuals. (2) The physician under review shall be included on any substantive communications by any party with the external reviewers selected under subdivision (c)(1)(A) of this section. (d) At the conclusion of the investigation, the physician under review shall be informed of the determination of the professional review body.

Ark. Code Ann. § 20-9-1310 Standards for hearings and related matters.

(a)(1) A physician who is the subject of a proposed professional review action shall be given notice of the proposed professional review action, the basis for the proposed professional review action, and the right to a hearing. (2) Subdivision (a)(1) of this section does not entitle a physician to a hearing if the proposed professional review action will not adversely affect the physician's clinical privileges or medical staff membership. (b)(1) A hearing shall be held before a hearing officer, arbitrator, hearing panel, or combination of hearing officer, arbitrator, or hearing panel. (2) A hearing officer or arbitrator shall: (A) Be independent of all parties involved; (B) Have no conflict of interest; and (C) Not: (i) Have served as an attorney for the hospital or the physician under review at any time within two (2) years before the hearing date; or (ii) Be affiliated with a law firm that has represented the hospital or the physician under review at any time within two (2) years before the hearing date. (3)(A) The medical staff bylaws shall govern the appointment of members of a hearing panel subject to the requirements of this subsection. (B) The members of a hearing panel may be members of the medical staff of the hospital. (C) The members of the hearing panel shall: (i) Disclose any potential conflicts of interest before the hearing; and (ii) Agree to exercise unbiased, independent, and professional judgment when evaluating the competence or professional conduct of the physician under review. (4)(A) A physician under review shall have a reasonable opportunity to raise the issue of a potential conflict of interest or other concern related to a hearing officer, arbitrator, or member of a hearing panel. (B) The medical staff bylaws shall establish a process for considering and resolving any potential conflicts of interest. (c)(1) Before the hearing, the professional review body and the physician under review shall provide the opposing party with a list of any witnesses expected to testify and copies of any documents expected to be introduced at the hearing. (2) In advance of the hearing, the hospital administration, professional review body, and the physician under review shall disclose all relevant information to each other. (d) At the hearing, the physician under review shall have the right to: (1) Be present and present evidence on his or her own behalf; (2) Be represented by an attorney or another individual of the physician's choice at the hearing; (3) Call, examine, and cross-examine witnesses; and (4) Submit a written statement. (e) Upon completion of the hearing, the physician under review has a right to receive: (1) The written recommendation of the hearing officer, arbitrator, or hearing panel, including a statement of the basis of the recommendation; and (2) A copy of the record of the hearing upon request and payment of any reasonable charges for the preparation of the record. (f) After the hospital takes final action on the recommendation from the hearing, the physician under review is entitled to receive a written decision, including a statement of the basis for the decision. (g) Any dispute over the relevancy or method of discovery or any other dispute that arises during the hearing process shall be resolved by the hearing officer, arbitrator, or hearing panel.

Ark. Code Ann. § 20-9-1311 Nonwaivable.

(a) Unless part of a mutually agreed upon mediation or settlement, a provision in an agreement, policy, procedure, or contract, including bylaws, that purports to waive any provision of this subchapter is void. (b) However, the time periods for compliance with procedural requirements may be waived by mutual consent of the parties on a case-by-case basis.

Ark. Code Ann. § 20-9-1312 Applicability.

On and after August 1, 2017, this subchapter shall apply to any investigation or professional review activity at any stage.

Ark. Code Ann. § 20-9-1313 Remedy.

(a) Within sixty (60) days of a final decision that adversely affects a physician, a physician may file a petition to remedy a violation of this subchapter by filing the petition in: (1) The circuit court of the county in which the professional review activity occurred; or (2) The circuit court of an adjoining county. (b)(1) After receiving a petition, the court shall review the record of the professional review activities and professional review action. (2) The record shall consist of: (A) The transcripts and minutes of any meetings or hearings; (B) Correspondence; (C) Internal and external reviews; and (D) All other relevant information pertaining to the matter before the professional review body. (3) The hospital shall transmit the record, but the court may require or permit subsequent corrections or additions to the record. (4) The review conducted by the court shall be confined to the record, except upon a showing of good cause to go beyond the record. (5) The court may hear, upon request, oral arguments and receive written briefs. (6) Absent a showing of bad faith, a member of the medical staff who participated in the professional review activity shall not be compelled to testify in court under this subsection. (c) Except as provided in subsection (e) of this section, the court may order any relief within the purview of the circuit court to remedy the violation of this subchapter. (d)(1) If a physician prevails under this section, the physician shall be entitled to reasonable attorney's fees, costs, and expenses as determined by the court. (2) A defendant who prevails shall be entitled to reasonable attorney's fees, costs, and expenses as determined by the court to the extent permitted under the Health Care Quality Improvement Act of 1986, 42 U.S.C. § 11113, as existing on January 1, 2017. (e) Except as expressly permitted by state law or federal law, a professional review body or its members, agents, or employees are not liable for civil damages as a result of making a decision or recommendation in good faith in connection with a professional review activity or professional review action or furnishing any records, information, or assistance in good faith to a professional review body in connection with a professional review activity. (f)(1) The remedies provided for in this section do not supplant any other remedy available under law to a physician. (2) If a physician has more than one (1) cause of action, all causes of action may be joined in the same pleading.

Ark. Code Ann. § 20-9-1401 Definitions.

As used in this subchapter: (1) “Child care facility” means a facility licensed under the Child Care Facility Licensing Act, § 20-78-201 et seq.; (2) “Freestanding birthing center” means a facility, institution, or place, which is not an ambulatory surgical center or a hospital or in a hospital, organized to provide family-centered maternity care for women and childbearing families in which births are planned to occur in a homelike atmosphere away from the mothers' residences following a low-risk pregnancy; (3) “Hospital” means an institution that has been licensed, certified, or approved by the Division of Health Facilities Services as a hospital; (4)(A) “Maternity unit” means a unit or place in a hospital in which women are regularly received and provided care during all or part of the maternity cycle. (B) “Maternity unit” does not include an emergency department or similar place dedicated to providing emergency health care; (5) “Parent” means: (A) Either parent; (B) If the parents are separated or divorced or their marriage has been dissolved or annulled, the parent who is the residential parent and legal custodian of the child; and (C) A prospective adoptive parent with whom a child is placed; and (6) “Shaken baby syndrome” means signs and symptoms resulting from the violent shaking or the shaking and impacting of the head of an infant or child, including without limitation: (A) Retinal hemorrhage; (B) Subdural hematoma; and (C) Cerebral edema.

Ark. Code Ann. § 20-9-1402 Shaken baby syndrome education program established.

(a) The Secretary of the Department of Health shall establish the shaken baby syndrome education program by: (1) Not later than one (1) year after August 16, 2013, developing educational materials that present readily comprehensible information for new parents on shaken baby syndrome; and (2) Making available on the Department of Health website in an easily accessible format the educational materials developed under subdivision (a)(1) of this section. (b)(1) An individual or entity may create educational materials concerning shaken baby syndrome. (2) An individual or entity that develops educational materials under subdivision (b)(1) of this section shall submit the materials for approval by the department before distributing the educational materials. (3) If the department approves educational materials submitted under subdivision (b)(2) of this section, the individual or entity may distribute the educational materials at the individual's or entity's expense. (c)(1) Annually beginning on or before January 1, 2014, the secretary shall assess the effectiveness of the shaken baby syndrome education program. (2) The department shall submit a biennial report of the assessment under subdivision (c)(1) of this section to the Chair of the House Committee on Public Health, Welfare, and Labor and the Chair of the Senate Committee on Public Health, Welfare, and Labor.

Ark. Code Ann. § 20-9-1403 Distribution of shaken baby syndrome educational materials.

(a) A copy of the shaken baby syndrome educational materials developed under § 20-9-1402 or comparable material shall be distributed: (1) By a child birth educator, a pediatric physician's office, or an obstetrician's office to an expectant parent who uses the services of the child birth educator or staff; (2) By a hospital or freestanding birthing center in which a child is born to the child's parent who is present at the hospital or freestanding birthing center before the child is discharged from the facility; (3) By a child care facility to the parent with whom the child resides; and (4) By a child care facility to each employee of the child care facility. (b) An entity or a person required to distribute educational materials under subsection (a) of this section is not subject to civil or criminal liability for an injury, a death, or a loss to a person or property resulting from the dissemination of, or failure to disseminate, the educational materials.

Ark. Code Ann. § 20-9-1404 Data on shaken baby syndrome.

(a) At the conclusion of a child maltreatment investigation under the Child Maltreatment Act, § 12-18-101 et seq., if a child has been shaken or has an abusive or nonaccidental head trauma, the investigative agency shall identify the type of physical abuse in the child welfare information system. (b) The Department of Human Services shall include data on the number of children who suffer abusive head trauma, nonaccidental head trauma, and shaken baby syndrome in the annual Arkansas Child Welfare Report Card required under § 9-32-204.

Ark. Code Ann. § 20-9-1405 Rules.

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

Ark. Code Ann. § 20-9-1501 Definitions.

As used in this subchapter: (1) "Biological sex” means the biological indication of male and female in the context of reproductive potential or capacity, such as sex chromosomes, naturally occurring sex hormones, gonads, and nonambiguous internal and external genitalia present at birth, without regard to an individual’s psychological, chosen, or subjective experience of gender; (2) “Cross-sex hormones” means: (A) Testosterone or other androgens given to biological females in amounts that are larger or more potent than would normally occur naturally in healthy biological sex females; and (B) Estrogen given to biological males in amounts that are larger or more potent than would normally occur naturally in healthy biological sex males; (3) “Gender” means the psychological, behavioral, social, and cultural aspects of being male or female; (4) “Gender reassignment surgery” means any medical or surgical service that seeks to surgically alter or remove healthy physical or anatomical characteristics or features that are typical for the individual’s biological sex, in order to instill or create physiological or anatomical characteristics that resemble a sex different from the individual’s biological sex, including without limitation, genital or nongenital gender reassignment surgery performed for the purpose of assisting an individual with a gender transition; (5) “Gender transition” means the process in which a person goes from identifying with and living as a gender that corresponds to his or her biological sex to identifying with and living as a gender different from his or her biological sex, and may involve social, legal, or physical changes; (6)(A) “Gender transition procedures” means any medical or surgical service, including without limitation physician's services, inpatient and outpatient hospital services, or prescribed drugs related to gender transition that seeks to: (i) Alter or remove physical or anatomical characteristics or features that are typical for the individual’s biological sex; or (ii) Instill or create physiological or anatomical characteristics that resemble a sex different from the individual’s biological sex, including without limitation medical services that provide puberty-blocking drugs, cross-sex hormones, or other mechanisms to promote the development of feminizing or masculinizing features in the opposite biological sex, or genital or nongenital gender reassignment surgery performed for the purpose of assisting an individual with a gender transition. (B) “Gender transition procedures” do not include: (i) Services to persons born with a medically verifiable disorder of sex development, including a person with external biological sex characteristics that are irresolvably ambiguous, such as those born with 46 XX chromosomes with virilization, 46 XY chromosomes with undervirilization, or having both ovarian and testicular tissue; (ii) Services provided when a physician has otherwise diagnosed a disorder of sexual development that the physician has determined through genetic or biochemical testing that the person does not have normal sex chromosome structure, sex steroid hormone production, or sex steroid hormone action; (iii) The treatment of any infection, injury, disease, or disorder that has been caused by or exacerbated by the performance of gender transition procedures, whether or not the gender transition procedure was performed in accordance with state and federal law or whether not funding for the gender transition procedure is permissible under this subchapter; or (iv) Any procedure undertaken because the individual suffers from a physical disorder, physical injury, or physical illness that would, as certified by a physician, place the individual in imminent danger of death or impairment of major bodily function unless surgery is performed; (7) “Genital gender reassignment surgery” means a medical procedure performed for the purpose of assisting an individual with a gender transition, including without limitation: (A) Surgical procedures such as penectomy, orchiectomy, vaginoplasty, clitoroplasty, or vulvoplasty for biologically male patients or hysterectomy or ovariectomy for biologically female patients; (B) Reconstruction of the fixed part of the urethra with or without a metoidioplasty; or (C) Phalloplasty, vaginectomy, scrotoplasty, or implantation of erection or testicular prostheses for biologically female patients; (8) “Healthcare professional” 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; (9) “Nongenital gender reassignment surgery” means medical procedures performed for the purpose of assisting an individual with a gender transition including without limitation: (A) Surgical procedures for biologically male patients, such as augmentation mammoplasty, facial feminization surgery, liposuction, lipofilling, voice surgery, thyroid cartilage reduction, gluteal augmentation, hair reconstruction, or various aesthetic procedures; or (B) Surgical procedures for biologically female patients, such as subcutaneous mastectomy, voice surgery, liposuction, lipofilling, pectoral implants, or various aesthetic procedures; (10) “Physician” means a person who is licensed to practice medicine in this state; (11) “Puberty-blocking drugs” means gonadotropin-releasing hormone analogues or other synthetic drugs used in biological males to stop luteinizing hormone secretion and therefore testosterone secretion, or synthetic drugs used in biological females which stop the production of estrogens and progesterone, when used to delay or suppress pubertal development in children for the purpose of assisting an individual with a gender transition; and (12) “Public funds” means state, county, or local government monies, in addition to any department, agency, or instrumentality authorized or appropriated under state law or derived from any fund in which such moneys are deposited.

Ark. Code Ann. § 20-9-1502 Prohibition of gender transition procedures for minors.

(a) A physician or other healthcare professional shall not provide gender transition procedures to any individual under eighteen (18) years of age. (b) A physician, or other healthcare professional shall not refer any individual under eighteen (18) years of age to any healthcare professional for gender transition procedures. (c) A physician or other healthcare professional is not prohibited from providing any of the following procedures which are not gender transition procedures to an individual under eighteen (18) years of age: (1) Services to persons born with a medically verifiable disorder of sex development, including a person with external biological sex characteristics that are irresolvably ambiguous, such as those born with 46 XX chromosomes with virilization, 46 XY chromosomes with undervirilization, or having both ovarian and testicular tissue; (2) Services provided when a physician has otherwise diagnosed a disorder of sexual development that the physician has determined through genetic or biochemical testing that the person does not have normal sex chromosome structure, sex steroid hormone production, or sex steroid hormone action; (3) The treatment of any infection, injury, disease, or disorder that has been caused by or exacerbated by the performance of gender transition procedures, whether or not the gender transition procedure was performed in accordance with state and federal law or whether not funding for the gender transition procedure is permissible under this subchapter; or (4) Any procedure undertaken because the individual suffers from a physical disorder, physical injury, or physical illness that would, as certified by a physician, place the individual in imminent danger of death or impairment of major bodily function unless surgery is performed.

Ark. Code Ann. § 20-9-1503 Prohibition on use of public funds for gender transition procedures.

(a) Public funds shall not be directly or indirectly used, granted, paid, or distributed to any entity, organization, or individual that provides gender transition procedures to an individual under eighteen (18) years of age. (b) Healthcare services furnished in the following situations shall not include gender transition procedures to an individual under eighteen (18) years of age: (1) By or in a healthcare facility owned by the state or a county or local government; or (2) By a physician or other healthcare professional employed by state or a county or local government. (c) Any amount paid by an individual or an entity during a taxable year for provision of gender transition procedures or as premiums for health care coverage that includes coverage for gender transition procedures is not tax-deductible. (d) The Arkansas Medicaid Program shall not reimburse or provide coverage for gender transition procedures to an individual under eighteen (18) years of age.

Ark. Code Ann. § 20-9-1504 Enforcement.

(a) Any referral for or provision of gender transition procedures to an individual under eighteen (18) year of age is unprofessional conduct and is subject to discipline by the appropriate licensing entity or disciplinary review board with competent jurisdiction in this state. (b) A person may assert an actual or threatened violation of this subchapter as a claim or defense in a judicial or administrative proceeding and obtain compensatory damages, injunctive relief, declaratory relief, or any other appropriate relief. (c)(1) A person shall bring a claim for a violation of this subchapter no later than two (2) years after the day the cause of action accrues. (2) An individual under eighteen (18) years of age may bring an action throughout their minority through a parent or next friend, and may bring an action in their own name upon reaching majority at any time from that point until twenty (20) years after reaching the age of majority. (d) Notwithstanding any other provision of law, an action under this subchapter may be commenced, and relief may be granted, in a judicial proceeding without regard to whether the person commencing the action has sought or exhausted available administrative remedies. (e) In any action or proceeding to enforce a provision of this subchapter, a prevailing party who establishes a violation of this subchapter shall recover reasonable attorneys’ fees. (f)(1) The Attorney General may bring an action to enforce compliance with this subchapter. (2) This subchapter does not deny, impair, or otherwise affect any right or authority of the Attorney General, the State of Arkansas, or any agency, officer, or employee of the state, acting under any law other than this subchapter, to institute or intervene in any proceeding.

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