Debate over new quality-oversight measure for psychiatric treatment facilities yields no motion

Representative Frank Kavanaugh, sponsor of House Bill 1446, told the committee the bill grew out of a mental-health work group and aims to address quality-of-care gaps for children in psychiatric residential treatment facilities (PRTFs) and similar beds. "This bill arose out of our mental health work group," he said, adding the legislation seeks a single standard of quality so children receive consistent care regardless of setting.

The bill was amended to explicitly include children who are victims of human trafficking. Kavanaugh also told the committee the work group had raised payment-rate issues and said lawmakers raised the rate paid to some facilities to $502 per placement to help address staffing and quality concerns: "What 1 of the things that we did was we raised the the rate that we're actually paying for these facilities to $502 and we thought that was gonna help them with some quality of care issue because we did feel ... that was the right thing to do." (Representative Kavanaugh)

Witnesses raised competing views about whether the bill would duplicate existing oversight. Sherry Wilding, a licensed psychological examiner and hospital administrator, said hospitals and PRTFs already report quality metrics to the Arkansas Department of Health, the Joint Commission, and CMS and that an added entity would create a new cost to the state and duplicate functions. "There are quality standards contained in those rules and regulations, as well as the joint commission, which requires which hospitals are required to have for accreditation," she said, and warned of administrative burden.

DHS representative Mark White acknowledged multiple regulators review facilities but said the proposed DHS review is intended to fill gaps for children placed by non-state payers or out-of-state entities. White told senators DHS believes it can absorb the function without adding cost and that the agency has worked to reduce duplicative visits by coordinating inspections across divisions.

Several senators, including Senator Sullivan and Senator Boyd, pressed for a side-by-side comparison of current regulatory visits and the proposed new review to avoid redundancy that could further burden providers and harm quality. Shane Frazier, CEO of Pinnacle Point Behavioral Health System, asked that acute-care hospitals with subacute behavioral-health services be excluded from the bill because they are already subject to multiple accrediting bodies.

After extended questioning and testimony, the committee did not make a motion to advance HB 1446 at this meeting. Sponsors and DHS staff said they would continue to work with stakeholders on language and coordination between agencies before bringing the matter back.