ALC-Executive Subcommittee
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0:00
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Senator Ben Gilmore
Unverified
6:30
All right, Chair Cesar Quorum, thank you all for being here, for your attention today. We're going to go ahead and get started. I know we've got a busy day, a lot of things going on, so I'll invite Ms. Weatherton with DHS, Smith and Stone to come to the table, please, and present the emergency rule, or whoever is coming to the table to present the emergency rule and if you
would recognize yourself when you get set Melissa Weatherton director
Speaker 5
7:19
for Medicaid specialty populations at DHS Martina Smith director for the division of provider services and
Speaker 6
7:24
quality Assurance. Paula Stone, Director of the Office of Substance Abuse and Mental Health.
Speaker 5
7:38
Okay, you're recognized. Proceed. Thank you. So we're here today asking to get approval on an
emergency rule that falls under Act 636 that was passed during this past legislative session. Ms. Smith is over our licensure unit. Before you today is a new licensure manual and Ms. Stone is over our behavioral health, and there is a new behavioral health Medicaid manual. Act 636 changed the oversight of psychiatric residential treatment facilities. It moved it from a board to under the
Office of Long-Term Care, making it a long-term care facility. So Before You is a brand new Office of Long-Term Care licensure manual to regulate PRTF providers, and a new Medicaid manual to strengthen the requirements of what services are provided in those facilities. We've done a number of enhancements throughout the process, closely working with the providers and other stakeholders of note.
I would say that prior to these manuals being put in place, children could go into one of these facilities at age 5. We are raising it to age 10. These manuals also bar any use of seclusion or mechanical restraints. They increase ratio requirements during the day. They increase site and supervision requirements throughout the night. Let's see. They also require additional mandatory training in behavioral health, and they require a series of preparedness plans and stricter safety standards around who can be in the wing, how close in age the kids have to be.
In the Medicaid manual, I think some of the things to point out that are additional requirements, it's mandatory hours of what we define as active treatment. We require some heightened around education, because they do provide education in the PRTFs. And let me see if I'm missing anything we need to point out. Oh, we're mandating a series of monthly reporting requirements that are new to the facilities where they're going to report monthly to us on the use of chemical restraints, psychotropic drugs.
And they're going to report to us on out-of-state children and their discharge plans. every month and they are also going to report um what am i missing ladies restraint psychotropic drugs and out-of-state children and and treatment plans and i'll stop there and see if paula or martina want to add anything that i've missed they want to point out we're happy to take
Senator Ben Gilmore
Unverified
10:37
questions okay nothing else from you ladies okay going first to
Senator Justin Boyd
Unverified
10:41
senator boyd you're recognized thank you mr chair so you said or i understood you to say that you were raising the age from five to ten and so i'm just curious is that going to create some other issue like are we going to start hearing from judges or schools or parents or somebody saying hey there's nowhere to stick my child who has whatever these significant needs are so what we have put
Speaker 5
11:09
in the regs that effective july 1 no child under the age of 10 will be
admitted to a facility we're not asking for any child that's under that age to be discharged they can stay until their program's completed but senator boy we've had extensive conversations on yes we do understand that these some of these children will still need services still need treatment still need placements um paula can speak more towards this but based on what we've been looking at those age ranges between five and nine you know we're really focused on doing through Medicaid more in-home type intensive services we have other things that we think
would be more effective for that younger age
Chair
Unverified
11:54
of children yeah for those young children that we made sure that we have a new service that we're putting into place we've been piloting is called family-centered treatment and we know that particularly for any child but particularly for those under the age of 10 services are only as good as the family's involvement because these are short-term services short-term being about six months in a psychiatric residential
treatment facility so all of these children are going to get treatment and then they're going to go back home and so we're really focusing on keeping those children under the age of 10 in their communities in their schools so building out those services that support them in those environments which they would return anyway so really having the parent involvement and in doing a service called family-centered treatment we think is critically important for those younger children thank
Senator Ben Gilmore
Unverified
12:48
you okay uh going to representative wardlaw you're recognized
Representative Jeff Wardlaw
Unverified
12:51
thank you mr chair i guess i'm just trying to figure out
what's the emergency walk me through why this has to be done right now when there's a bunch
of bills that are passed during the session to deal with medicaid and i
Speaker 5
13:10
don't see you down here for all those with emergency rules as well absolutely so under act 636 it actually that that law had an emergency clause on it and at the time what it did was it removed these psychiatric residential treatment facilities
out from underneath the oversight of the board they were under so since the emergency clause on the act has been in effect we have not had regulatory standards to be able to regulate these facilities but on page three number 10 you answered
Representative Jeff Wardlaw
Unverified
13:35
that question no it's the proposed rule the result of a recent legislation passed by the general assembly so why would you answer that as no if that's your answer because representative board
Speaker 5
13:48
law i did see an email come through that there was a mistake and that was corrected and i'm assuming that what happened is y'all did not
get the corrected version. They've gone back in and said, yes, there was a state statute that caused this
Representative Jeff Wardlaw
Unverified
14:02
to be an emergency. It also says there's no financial impact. Can you walk me through how there's no financial impact? So what are we taking
Speaker 5
14:13
away if we're gaining this new licensure? So yes, there actually is no financial impact. So we have, we already have an established office of long-term care already have surveyors in that office they already go out for other
long-term care facilities like intermediate care facilities assisted livings and nursing homes we also utilize a vendor in this space to do some of this work already and the vendor is
Speaker 33
14:41
not going to charge us any additional dollar amount to have these additional requirements added to their contract. Okay, thank you.
Chair
Unverified
14:54
Okay, Senator Irvin, you're recognized.
Senator Missy Irvin
Unverified
14:59
Thank you. Thank you for being here and for the proposed rule. A couple of questions. Do you as an agency have the ability to craft the type of reports that we need or wanted under this proposed rule and and manual yes under we um martina smith and her
Speaker 5
15:15
team right now are developing the oltc approved templates so that they're all consistent that we will then send out to the providers for their monthly reporting okay um will will that ever come back before the legislature
Senator Missy Irvin
Unverified
15:32
the types of information that you're going to be requesting do we ever get a chance to see that before they start just because sometimes we we send things out asking for data but it's not y'all you're doing that but there are things that we may also want to see so i really think i mean i personally would like to see this i'm sure that representative kavanaugh would as well it's her bill and i was able to sponsor it on the senate side for her but i'm very interested in making sure that we're tracking any victims of human trafficking and their the length of stay at their
facility at these facilities and the treatment and then also not that the treatment stops at that just that facility because they may not be equipped that's what I'm interested in they may not be equipped to be able to really fully treat some of these children that they receive and I don't want them just to stop it stop there they I want to see them being engaged to make sure even if it's outside of that facility that we get these these kids to the facilities where they really can get the the treatment that they really need if even if that facility can't offer it or if there's
any outside services that they can collaborate with in order to get that treatment so very I want to know those kinds of levels of details and i think reporting we want to make sure that we're best utilizing these facilities but just not warehousing kids and that's what i'm interested in so um okay that that's and i'd like to see what those reports are going to look like and the kind of information that are going to be asked by them absolutely thank you thank you senator uh representative
Senator Ben Gilmore
Unverified
17:16
kavanaugh you're recognized thank you mr. chair thank y'all
Representative Frances Cavenaugh
Unverified
17:21
for being here um i appreciate the hard work on the rules because uh during session that was one of our uh real concerns is if we could get these rules done quick enough because we knew with the emergency clause that um we were going to have that time frame where there wouldn't be any regulation um and for me this bill was brought because we had really no regulation on a lot of these problems and it created a real issue but you feel comfortable with these new regulations that we're going to be able to accomplish what we really want it to with the the legislation
is we're going to have licensure they're going to be standard set we're going to be able to keep control of how many kids are in these facilities we're going to be able to look at how many outside children we have we're going to be able to have treatment plans for these kids so that they're not in this revolving door all this is going to is addressed in these rules is that correct yes ma'am
Senator Ben Gilmore
Unverified
18:22
okay thank you okay and then the question i have and i think i've uh expressed this to
miss man who's sitting on front row back there um when can we expect the permanent rule to be promulgated so we had a
Speaker 5
18:34
discussion about that internally yesterday we are going to get that right back at you guys um so we need to put that would be when we need to put it out for public comment that's our next step but our goal was
Senator Ben Gilmore
Unverified
18:47
to get that going next week okay so you'll be filing that through the normal process next week
Speaker 11
18:52
yes sir we have to start public comment first
Senator Ben Gilmore
Unverified
18:54
but yes i understand but i want that to to start generally with emergency rules i like to know that we have
Representative Howard M. Beaty, Jr.
Unverified
19:00
a permanent rule coming representative baity uh you're recognized thank you mr chair just just one question i'm over here kind of hiding behind this
chair um this rule kind of came out of a working group uh that for both outside and inside is that correct it was you know several months of working group to get to this point and um and get this before us today is that correct yes sir
Speaker 5
19:25
we had we've had a lot of discussions with the providers um that we've worked very collaboratively
on these rules um we've spent a lot
Speaker 33
19:32
of time together um going through the different
Representative Howard M. Beaty, Jr.
Unverified
19:35
pieces well again i just want to echo the comments thank you for the the timeliness of getting this to to the
Senator Ben Gilmore
Unverified
19:45
group so appreciate the work thank you okay members seeing no other questions as per our practice in the committee uh without objection the proposed emergency rule is reviewed and approved with review and approval being effective upon adjournment of legislative council friday june 20 20 25. all right thank you seeing objection thank you
all right members uh we'll move now to item c and that will be the motion picture final report from olsberg spi and i think we have joining us by video conference is maureen and leon if you would introduce yourselves for the committee and then we'll open it up for you to present and then we'll take questions after that so if you would I don't know which would prefer to start but I'll leave it to y'all you're recognized thank you thank
Speaker 49
20:40
you Mr. Chair and thank you to the to the executive
Speaker 51
20:43
subcommittee my name is Leon Ford I'm CEO of Oldsburg SBI and I'm joined by my
Senator Ben Gilmore
Unverified
20:57
colleague Looks like we're having some technical difficulties, so if you'll bear with us. It's pretty great, actually.
Speaker 62
21:25
Because what time is it there, Marty? Seven hours later, six
Speaker 61
21:29
hours later. Yeah, it's getting close to night-night time.
Senator Ben Gilmore
Unverified
22:25
okay members we're trying to reach out to them it is on their end and they are I think seven hours ahead of us across the pond so I think we'll take maybe five minute recess to get this figured out and then we'll come back
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22:55
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Okay.
Senator Ben Gilmore
Unverified
28:55
All right, if I can have your attention, please, members and those in the audience. We are having some technical difficulties that appears we will not be able to continue this. So we will reschedule this presentation for a later meeting. Apologize for the inconvenience. Apologize for all those who were here to ask questions and participate. So with that, I don't think we have any further business, and I will say we're adjourned. Thank you so much.
Agenda
A. Call to Order
B. Consideration of an Emergency Rule: Department of Human Services (DHS) - Psychiatric Residential Treatment Facility Services for Under Age 21.
C. Presentation of the Arkansas Motion Picture Study Final Report - Olsberg SPI
D. Other Business
E. Adjournment
Documents
Speakers
Senator Ben Gilmore
Unverified
Speaker 5
Speaker 6
Senator Justin Boyd
Unverified
Chair
Unverified
Representative Jeff Wardlaw
Unverified
Speaker 33
Senator Missy Irvin
Unverified
Representative Frances Cavenaugh
Unverified
Speaker 11
Representative Howard M. Beaty, Jr.
Unverified
Speaker 49
Speaker 51
Speaker 62
Speaker 61