Healthy Communities

Rules

The State Board of Health is empowered to make all necessary and reasonable rules of a general nature for the protection of the public health and safety; for the general amelioration of the sanitary and hygienic conditions within the state; for the suppression and prevention of infectious, contagious, and communicable diseases; for the proper enforcement of quarantine, isolation, and control of such diseases; and for the proper control of chemical exposures that may result in adverse health effects to the public. The Department of Health is the state agency responsible for implementing the Board's rules.

The Board updates its rules on a continuing basis. The Board must follow the Administrative Procedure Act ("APA") to amend, repeal or adopt a rule. 

The following questionnaire must also be utilized for filing proposed rules: Questionnaire For Filing Proposed Rules.

An essential part of the APA allows the public to comment on any rule being amended, repealed or proposed and the Board values your comments and questions.

Please see the Final Rules Table of Contents to view the Board's current rules.


Public Health Emergency Regulatory Suspensions Pursuant to Executive Order 20-06 and 20-16

On March 17, 2020, Governor Asa Hutchinson issued Executive Order 20-06, ordering state agencies to “identify provisions of any regulatory statute, agency order or rule that in any way prevents, hinders, or delays the agency’s ability to render maximum assistance” to Arkansans during the COVID-19 health emergency. The Order instructed state agencies to identify regulatory statutes, orders, and rules that are hindering or preventing the rapid response necessary to combat the spread of and recovery from COVID-19. The Order requires agencies to identify any such statutes, orders, or rules on its website. Once posted, the statute, rule, or order is deemed suspended for thirty (30) days from the effective date of EO 20-06. On April 13, 2020, Governor Asa Hutchinson issued Executive Order 20-16, extending the suspension until this emergency subsides.

The Secretary of Health has identified certain statutes and rules issued by the Department that he deems a hindrance to mitigating the spread of COVID-19.

They include the following:

Dept of Health Medical Marijuana patient applications Arkansas Medical Marijuana Amendment of 2016:
Amendment 98

Extending the expiration dates on cards expiring in the 30 day period until emergency declaration is concluded and crisis passes.

Telehealth for the PWC is temporarily allowed until emergency declaration is concluded

Dept of Health Home Health Agencies 20-10-806 and Rules for Home Health Agencies Surveys and inspections are temporarily suspended, with the exception of immediate jeopardy complaints:
  • Suspended RN supervisory visits
  • Allow extension of current care.
Dept of Health, Hospital Term: “Physician” is assumed to be that of a medical doctor.

Emergency Definition:

“Physician” means Qualified Medical Professional, working within their scope of practice.

Qualified Medical Professional also includes:

  • Physician assistant
  • Nurse practitioner
  • Clinical nurse specialist
  • Certified registered nurse anesthetist
  • Certified nurse-midwife
  • Clinical social worker
  • Clinical psychologist
  • Anesthesiologist’s Assistant
  • Registered dietician or nutrition professional
Dept of Health State Hospital Rules The Medical Staff will be responsible for assuring these professionals provide quality care, they also can approve roles and responsibilities (privileges) to members.

Section 6: Medical Staff

B.  Medical Staff Bylaws

1.  Medical Staff shall be responsible to the Governing Body of the facility for the quality of medical care provided for patients in the hospital and for the clinical and professional practices of members.
Dept of Health Arkansas Rules for Hospitals and Related Institutions, Section 11.E.1 There shall be no more beds maintained in the building than the number of beds for which the hospital is licensed except in the case of a public disaster or national emergency and then only as a temporary measure. There is no need to request an increase in licensed beds at this time as we are under a National/State Emergency with the Covid-19 outbreak.
Dept. of Health Newborn Screening Program 20-15-301 and Act 113 of 1995 CAH programs do not provide direct services for newborn screening or infant hearing. CAH programs oversee the following statutes and rules which require person-to-person contact during service delivery. Each of these services occur following birth of a child where person-to-person contact is required.
Dept. of Health Infant Hearing Program Act 1559 of 1999. 20-15-1501 CAH programs do not provide direct services for newborn screening or infant hearing. CAH programs oversee the following statutes and rules which require person-to-person contact during service delivery. Each of these services occur following birth of a child where person-to-person contact is required.
Dept. of Health Licensed Lay Midwifery LLM Rule 302.01 Risk Assessments.
Dept. of Health Licensed Lay Midwifery LLM Rule 302.02 Required Antepartum Services at or Near the Initiation of Care.
Dept. of Health Licensed Lay Midwifery LLM Rule 302.04.01 Routine antepartum visits must be made approximately every four (4) weeks during the first 28 weeks of gestation, approximately every two (2) weeks from the 28th to 36th weeks, and weekly thereafter until delivery.
Dept. of Health

Licensed Lay Midwifery

LLM Rule 302.05 Required Antepartum Services at 24-28 weeksRow
Dept. of Health

Licensed Lay Midwifery

LLM Rule 302.06 Required Antepartum Services at 35 to 37 weeks
Dept. of Health

Licensed Lay Midwifery

LLM Rule 302.07.01 Pre-Delivery Home Visit
Dept. of Health Emergency Medical Services Licensure Renewal Extended
Dept. of Health EMS/Trauma
  1. Aligning with NREMT and allow for provisional licensure for paramedic, EMT and AEMT licenses. Looking at the data, we will only have 24 paramedic candidates who could be eligible for this provisional certification, provided the students pass the paramedic course and the cognitive exam. We have an additional 118 paramedic candidates that will possibly be eligible by September. With clinical and field internships delayed, these student’s graduation dates may be delayed. While this may not gain a large number of individuals, under these particular circumstances, some may be better than none.
  2. EMS providers that did not recertify within the past 4 years, be looked at for temporary licensure as well. These individuals could not have had their license revoked or suspended by the Agency, but that were in good standing when they relinquished their license. All EMS providers work under the direction of a medical director, EMS agencies could vet these candidates with "temp" licenses and use them should their personnel get ill or are otherwise restricted from work.
Dept. of Health SECTION IV. GROUND AMBULANCE SERVICE LICENSURE CLASSIFICATION STANDARDS B. 6.

Tiered Response: A licensed ambulance service which has its own dispatch center and uses a dispatch process with certified emergency medical dispatchers that is recognized by the Section and is reliably able to differentiate and categorize the severity of the emergency call may assign the appropriate level of ambulance to that call. Services utilizing a tiered response dispatch process shall meet the following provisions:

a. The emergency call must be answered and screened by a certified Emergency Medical Dispatcher (EMD). EMD Certification must be obtained and maintained by a National Recognized Certifying body that is recognized by the Section of EMS.

b. The EMD Center must have Medical Direction oversight.

c. The service shall be required to have a quality assurance program in place to insure compliance with their service protocols and shall be reviewed by the Medical Director within 30 days of the call date.

d. All tiered responses that require a higher level intercept shall be tracked separately and reported to the section on a quarterly basis.

e. The service shall have a process in place that would specifically and reliably identify which calls are appropriate for less than the highest level of permitted ambulance and track all calls in which this dispatch process is implemented.

f. All requirements are met for the ambulance that is responding for equipment, personnel and licensure standards set forth in regulation.

 

Dept. of Health SECTION IV. GROUND AMBULANCE SERVICE LICENSURE CLASSIFICATION STANDARDS A. 2 -4

2. Licensed Paramedic Services shall have fifty percent (50%) or more ambulances permitted at the Paramedic level. Only licensed Paramedic Services may operate Paramedic ambulances.

3. Licensed Advanced EMT Services shall have fifty percent (50%) or more ambulances permitted at the Advanced EMT level. Only Advanced EMT and Paramedic Services may operate Advanced EMT ambulances.

4. Licensed EMT Services shall have ambulances permitted only at the EMT level. Paramedic and Advanced EMT Services may also operate EMT ambulances.

Dept. of Health D. Specific Standards 1. B., 3. B., 4. B., 5.B. Temporary Rule to Implement:
Remove the 2-minute reaction time. This will also for proper triage and screening to ensure the protection of the responding providers and allow for proper PPE to be used and ambulance to be configured if needed.
Dept. of Health SECTION V. PERMITTING OF GROUND EMERGENCY VEHICLES B. Vehicle General Standards 5., 9., 10

5. New ambulances replacing a permitted vehicle or being added to an existing service license must be inspected and permitted prior to being placed in service.

9. Only ambulances of a Paramedic or Advanced EMT Service shall be equipped with ALS Equipment unless a prior request for an upgrade has been made and approved by the department.

10. Temporary upgrades and downgrades of permitted ambulances are for mechanical reasons only and must be for a temporary period of time. Notice shall be made in writing on approved forms to the Department prior to any changes in equipment or staffing of permitted ambulances. Upgrades and downgrades are not permitted for the purposes of staffing. Permanent upgrades and downgrades shall follow the same guidelines as a new vehicle permit.

Dept. of Health SECTION V. PERMITTING OF GROUND EMERGENCY VEHICLES C. Ambulance Staffing Requirements 1-7 Temporary Rule to Implement:
Allow ambulance services to staff their ambulance with the highest trained personnel available to respond for service. This may include adding physicians, nurses, or other licensed healthcare providers.
Allow ambulance services to staff their ambulance with a driver who is not currently licensed as an EMS provider.
Dept. of Health SECTION IX. EDUCATION, TESTING AND LICENSURE OF PERSONNEL B. 5. Emergency Vehicle Operator: a. Successful completion of a National recognized First Responder Course of a minimum of 40 hours of training. b. Copy of a current signed Healthcare Provider CPR card (Must follow current American Heart Association Guidelines and require a hands on skills component) documenting completion of a CPR course designed specifically for healthcare providers. c. Emergency Vehicle Operator Course d. 10 hours of refresher training every two years to include emergency vehicle operations.
Dept. of Health SECTION IX. EDUCATION, TESTING AND LICENSURE OF PERSONNEL C. 1-2 Directive already issued to extend relicensure deadline to June 30, 2020 See directive here.
Dept. of Health Other Suggestions
  1. Mechanisms for temporary licensure of EMS providers who have lapsed licensure within the past 5 years. We could modify licensure and credentialing procedures to meet the exigencies of the situation while assuring public health and safety.
    • The state could implement a just-in-time training program, combined with appropriate and coordinated information to the EMS medical directors and EMS providers, that will help to ensure appropriate and competent medical care.
  2. All EMS providers to include points of referral for patients who need information but do not need emergency care or transport. Allow EMS Services to not transport patients that would not need emergency transport, but provide information of health alternatives, or connect them to a COVID evaluation hotline. the appropriate care may be to have individuals stay at home and practice social distancing and quarantine measures rather than be transported to a healthcare facility.
    • EMS Treat and Release - Community containment strategies designed to limit the spread of the virus may require patients be treated and released without transport. Additionally, healthcare facilities may become overwhelmed with patients, making it necessary to consider alternative options for patients who can be safely treated without transport.
    • If a treatment without transport role is deemed appropriate for EMS providers, the EMS medical director, in coordination with local public health authorities, should establish criteria and reporting requirements.
    • “Treat and release” and “treatment without transport” protocols require oversight by EMS medical directors.
    • EMS agencies and EMS medical directors should coordinate with the local public health authorities to pre-determine the destination of both suspected COVID-19 and positive COVID-19.
      • Appropriate education programs for EMS personnel, physicians, and the public should be established before the implementation of non-transport policies. 
Dept. of Health  Rules pertaining to Tuberculosis (2020) Temporarily suspending baseline screening for health care workers and long-term care
Dept. of Health Rules for Hospitals and Related Institutions Arkansas licensed ambulatory surgery center in good standing with the state and CMS may apply for a temporary hospital license. The temporary hospital license is dependent upon an application, and attestation that all hospital basic requirements are met, with the one exception of operation of an emergency department. The temporary hospital license for an Ambulatory Surgery Center is applicable only during the Governors Executive Order 20-03 and as amended by Executive Order 20-16, or any future Executive Order renewing the disaster and public health emergency specific to Covid-19. The temporary license is immediately terminated at the cessation of the Executive Order 20-03 , as amended by Executive Order 20-16 ,or any future Executive Order renewing the disaster and public health emergency specific to Covid-19.
Dept. of Health Trauma Trauma designation site surveys will be suspended for at least 6 months, with the ability to extend as needed. Trauma centers who designation expires during this time will remain designated at their current level until their next scheduled site survey. 
Dept. of Health Trauma Data abstraction requirements shall be suspended, with the understanding that data not enetered during this time will need to be entered at a later date.
Dept. of Health Trauma Staffing requirements and percentages may be suspended due to staff being furloughed due to COVID-19.
Dept. of Health Trauma Required QA/QI and other trauma-related meetings may also be suspended during this time period.

 

Rules Currently Being Amended, Repealed or Promulgated

 

Emergency Rules

Proposed Amendments to Existing Rules

Proposed New Rules 

Proposed Repeal of Rules

Recent Final Rules

Repealed Rules

Public Health Accrediation Board
Arkansas Department of Health
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4815 W. Markham, Little Rock, AR 72205-3867
1-800-462-0599