Multiple divisions within the Arkansas Department of Human Services and outside agencies are responsible for aspects of oversight or investigations into these facilities.
Placement and Residential Licensing Unit (PRLU)
Placement and Residential Licensing Unit (PRLU) is a unit of the Division of Childcare and Early Childhood Education. They are responsible for enforcing the Arkansas Minimum Licensing Standards. This unit is responsible for monitoring the facilities and responding to and investigating complaints involving the Arkansas Licensing Standards.
Child Welfare Agency Review Board (CWARB)
The Child Welfare Agency Review Board (CWARB) publishes and has the authority to amend the rules setting minimum licensing standards for the operation of child welfare agencies. They govern the granting, revocation, refusal, conversion, and suspension of licenses. They also have the authority to impose civil penalties. Members of this board are appointed by the governor and with the exception of an appointed representative the Division of Children and Family Services (DCFS) are all representatives of licensed placement or residential agencies that are regulated by this board. To date, the board has taken adverse action against an agency only once, including all of the classifications listed above, ever. That means:
- No agency has been fined;
- Only one agency’s license has been suspended or placed in a probationary status (which did not affect the ability to continue operating or admit new residents); and
- No license has ever been revoked, for any reason other than inactivity.
The CWARB meetings are public meetings. Prior meeting agendas, transcripts, and recordings are available here.
The Office of Long Term Care (OLTC)
The Office of Long Term Care (OLTC) implements the Centers for Medicare and Medicaid Services (CMS) regulations regarding restraint and seclusion. They review facilities once every 5 years and respond to complaints received regarding restraint and seclusion.
Health Services Permit Agency
The Health Services Permit Agency is responsible for issuing Permits of Approval (POAs) for several types of facilities including Residential Care Facilities and Psychiatric Residential Treatment Facilities. There has been a moratorium on the creation of additional PRTF beds in Arkansas since February 1, 2008. However, beds designated as exclusively for out-of-state residents have been exempted from the POA process and therefore have been able to proliferate in Arkansas despite the moratorium.
In furtherance of their objective to “evaluate the availability and adequacy of health facilities and health services” they have been tasked with surveying the PRTFs annually and publishing a report. Provider response to the survey has not been required and only between 4 and 8 providers have responded in the 5 reports published since 2013. At the time of the last report, 2019, there were 12 PRTFs. The providers that have chosen to respond each year has also not been consistent. A copy of the available reports can be viewed by clicking here.
Arkansas Child Abuse Hotline/Arkansas State Police Crimes Against Children Division (CACD)
Arkansas Child Abuse Hotline and the Crimes Against Children Division (CACD) of the Arkansas State Police Maltreatment allegations that are called into the Arkansas Child Abuse Hotline and then investigated by either the Crimes Against Children Division (CACD) of the Arkansas State Police or DHS are not reflected in the records provided here, other than a few referrals to local law enforcement agencies that are reflected in the reports of those agencies. Currently, substantiated maltreatment allegations originating in residential facilities are not being documented or tracked by facility by any agency or board. The abuse is almost exclusively attributed to the staff member or members involved and not to the facility.
Medicaid Inspection of Care
An Inspection of Care (IOC) must be performed at least once a year for every inpatient psychiatric provider, consistent with 42 CFR Part 456, Subpart I. The IOCs are to be performed by an independent contractor and they must include “personal contact and observation of each Medicaid recipient” and a “review of each beneficiary’s medical record.” At the end of 2019 it was determined that the contract for IOCs intended to cover PRTFs included language that limited its scope and excluded PRTFs. Only 2 PRTFs were reviewed in 2019 before the inspections were discontinued. A new contract was not put in place until May 1, 2021. The inspections that have resumed under the new contract have been limited to Medicaid Fee for Service clients and do not include clients that receive Medicaid benefits through a Provider-Led Arkansas Shared Savings Entity (PASSE). So far, all Arkansas Medicaid beneficiaries in PRTFs have been enrolled in a PASSE, therefore these inspections do not include client or guardian interviews, client record review, or medication pass observation. The IOCs can be viewed in our database.
Local Law Enforcement Agencies
Local Law Enforcement Agencies are often called to some facilities. Reasons for calls include elopements (runaway or missing youth), suicide attempts, overdoses, assault and battery, and agency assistance with controlling residents or maintaining order. Incidents investigated through the Child Abuse Hotline are also referred to local law enforcement for criminal investigation and prosecution.