Opinion ID: 1755687
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Heading: The Duties of the Commission

Text: The Association argues that the Commission is under an obligation to determine the actual needs of Arkansans for assisted-living accommodations. Pursuant to Ark. Code Ann. § 20-8-103(a) (Supp.2003), the Commission shall evaluate the availability and adequacy of health facilities and health services as they relate to long-term-care facilities. . . . Further, under Ark.Code Ann. § 20-8-103(b) (Supp.2003), the Commission shall designate those locales or areas of the state in which . . . the health service needs of the population are underserved. Under Ark.Code Ann. § 20-8-103(c) (Supp.2003), the commission may specify within locales or areas, categories of services which are underserved and overserved. . . . According to Ark.Code Ann. § 20-8-103(a) and Ark.Code Ann. § 20-8-104 (Supp.2003), the Commission is to evaluate the adequacy of health facilities, and through the Health Services Permit Agency, the Commission is responsible for permitting of health facilities. Permitting includes analysis of issues such as whether a new health facility is needed, whether the facility can be staffed, whether it is economically feasible, and whether it will foster cost containment. See, e.g., Ark.Code Ann. § 20-8-107 (Supp.2003). The purpose behind the statutes is to provide adequate and appropriate health facilities and services, for example as is set out in the Arkansas Assisted Living Act, where the purpose is stated as promoting the availability of appropriate services for those who need assisted-living services. Ark. Code Ann. § 20-10-1702(a)(1) (Supp.2003). The Association argues that one purpose of the Assisted Living Act is to ensure that `permits of approval' are based on actual needs of Arkansans. To the extent that the Association is arguing that this means assuring availability of adequate and appropriate facilities and services, the Association is correct. Whether Permits of Approval for Residential-Care Facilities Must be Counted as Permits of Approval for Assisted-Living Facilities The Association argues that residential-care facilities and assisted-living facilities serve the same needs of the same population. Based on this premise, the Association argues that under Ark.Code Ann. § 20-10-1709(a) (Supp.2003), which provides that permits of approval for residential-care facilities shall also be considered permits of approval for assisted living without further action, all permits of approval for residential-care facilities must be counted as permits for approval of assisted-living facilities. The Association argues that if this is not done, more accommodations for this population will be created than needed. The purpose of long-term-care statutes is to assure adequacy and availability of appropriate health care facilities and services to the populations that need them. The Association acknowledges that it is concerned about added competition, but also argues that overbedding of health care facilities can result in higher costs. Higher costs would certainly run counter to the cost containment concern noted in Ark.Code Ann. § 20-8-107. In that same section, the General Assembly notes concern for whether the facility can be adequately staffed and whether the project is economically feasible. Based on the purpose of long-term care regulation, to assure that adequate and appropriate health care facilities and services are available, it can certainly be argued that regulations that make provision of services unfeasible certainly do not comply with the obligation to provide adequate and appropriate health care facilities and services. The Commission evaluates the need for residential-care facilities and the need for assisted-living facilities separately. While as the Association notes, Ark.Code Ann. § 20-10-1709(a) provides that permits of approval for residential-care facilities shall be considered permits of approval for assisted-living facilities without further action, Ark.Code Ann. § 20-10-1704(h)(1) (Supp.2003) provides that residential-care facilities that choose not to become assisted-living facilities will be permitted to provide Medicaid personal care for those residents. Therefore, it is clear that the legislature did not intend that residential-care facilities automatically become assisted-living facilities without some action on the part of the residential-care facility. Consistent with this conclusion, Ark.Code Ann. § 20-10-1707 (Supp.2003) requires that a license be acquired in order to operate an assisted-living facility. Similarly, Ark.Code Ann. § 20-10-1702(a)(4) (Supp.2003) provides that [r]esidential care facilities have been providing many assisted-living services for years and should be allowed to participate in the assisted-living program. Also, residential-care facilities are to be included in the assisted-living program. Ark.Code Ann. § 20-10-1702(a)(5) (Supp.2003). Based on the above, we reject the claim by the Association that permits of approval for residential-care facilities must be counted as permits of approval for assisted-living facilities. Therefore, regulation 500M is not invalid on the basis that it conflicts with Ark.Code Ann. § 20-10-1709.