Arkansas Administrative Code
Agency 007 - ARKANSAS DEPARTMENT OF HEALTH
Division 35 - Center for Health Protection
Rule 007.35.22-003 - Rules Pertaining to the Arkansas Volunteer Immunity Act For Health Care Professionals and the Arkansas Volunteer Health Care Act
Universal Citation: AR Admin Rules 007.35.22-003
Current through Register Vol. 49, No. 2, February 2024
ARKANSAS STATE BOARD OF HEALTH
Rules Pertaining to the Arkansas Volunteer Immunity Act For Health Care Professionals and the Arkansas Volunteer Health Care Act Adopted 1999
100. GENERAL PROVISIONS
101. PURPOSE
(a) The purpose of these
rules is:
(1) To ensure compliance with Ark.
Code Ann. §
16-6-201, Ark. Code Ann. §
20-8-801, et seq., and Ark. Code
Ann. § 17-95-106;
(2) To provide for the registration of Free
or Low-Cost Health Care Clinics, as defined in Ark. Code Ann. §
16-6-201 and herein, under the
Arkansas Volunteer Immunity Act, to provide immunity from civil damages to
physicians and licensed health care professionals who are rendering free and
voluntary professional health care services;
(3) To provide for the registration of
healthcare providers and medical professionals, as defined in Ark. Code Ann. §
20-8-803, under the Volunteer
Health Care Act, who are providing Volunteer Healthcare Services to low-income
patients to provide immunity from civil damages to medical professionals who
contract with the Department of Health; and,
(4) To provide for the registration of
retired physicians and surgeons who are licensed to practice medicine by the
Arkansas State Medical Board under the laws of the State of Arkansas and who
are providing Volunteer Healthcare Services to provide immunity from civil
damages, under Ark. Code Ann. §
17-95-106.
(b) The Arkansas State Board of Health is
responsible for the registration of healthcare professionals, healthcare
providers; clinics pursuant to Act 276 of 1997, Act 958 of 2017, and Act 968 of
2021.
102. DEFINITIONS
(a) "Contract" means
an agreement executed in compliance with these rules between a healthcare
professional or a medical professional and the Department of Health or a
governmental contractor.
(b) "Free
or Low-Cost Health Care Clinic" means a clinic or part of a clinic that
(1) provides free or low-cost medical care;
and,
(2) accepts no insurance
payments for providing medical services.
(c) "Governmental contractor" means the
county health units, special purpose districts with healthcare
responsibilities, a hospital owned and operated by a governmental entity, or
any other healthcare entity designated by the department.
(d) "Health Care Professional" as defined in
Ark. Code Ann. §
16-6-201 under the Arkansas
Volunteer Immunity Act, means a person who:
(1) Is licensed or certified under subtitle 3
of Title 17 of the Arkansas Code Annotated; or
(2) Is a student or resident of a health care
profession program leading to a professional degree, a license, or
certification under Subtitle 3 of Title 17 of the Arkansas Code Annotated, who
is:
(A) Providing services within the scope of
the training of that student or resident; and
(B) Under the supervision of a person who is
licensed in the health care profession for which the student is seeking a
degree, a license, or a certification.
(e) "Healthcare provider" means:
(1) A free or charitable healthcare clinic
qualified as exempt from federal income taxation;
(2) A state or federally funded community
health center;
(3) A volunteer
corporation or volunteer healthcare provider that delivers healthcare services
to low-income patients; and
(4)
Other medical facilities with the primary purpose to deliver medical services
or treatment to humans and that include an office maintained by a medical
professional.
(f)
"Low-income patient" means a person who:
(1)
Is eligible for any category of the Arkansas Medicaid Program; or
(2) Does not have health insurance and whose
annual household income does not exceed three hundred percent (300%) of the
federal poverty level.
(g) "Medical professional" means:
(1) A physician, osteopathic physician, or
optometric physician;
(2) An
osteopathic physician assistant, physician assistant, or optometric physician
assistant;
(3) A chiropractic
physician;
(4) A podiatric
physician;
(5) A nurse licensed
under § 17-87-101 et seq.;
(6) A dentist, dental hygienist, or dental
assistant;
(7) A
pharmacist;
(8) An
optometrist;
(9) A
therapist;
(10) An addiction
specialist;
(11) A
counselor;
(12) A "Healthcare
Professional" as defined in herein;
(13) A dietitian or an individual who offers
dietary services; and
(14) A
student enrolled in an accredited program that prepares the student for
licensure in one (1) or more of the healthcare professions listed in
subdivisions 102(g)(1)-102(g)(12) of this section.
(h) "Volunteer Healthcare Services" means
healthcare services rendered voluntarily and without compensation to any person
located in the State of Arkansas by a healthcare professional who:
(1) Is registered by the Arkansas Department
of Health;
(2) Does not accept
insurance payments; and,
(3)
Provides healthcare services free of charge or for a nominal fee to persons who
are unable to pay.
200. REGISTRATION UNDER THE ARKANSAS VOLUNTEER IMMUNITY ACT
201. REGISTRATION FOR THE FREE OR LOW-COST HEALTH CARE CLINIC
(a) It shall be the duty of each Free or
Low-Cost Health Care Clinic to register with the Arkansas Department of Health
on forms approved by the Department, upon demonstration that the Free or
Low-Cost Health Care Clinic:
(1) is located
in the State of Arkansas;
(2) does
not accept any insurance payments; and,
(3) either:
(A) provides health care services free of
charge to persons unable to pay; or,
(B) provides health care services for a
nominal fee.
(b) Free or Low-Cost Health Care Clinics that
can demonstrate through the registration process that they are rendering free
or low-cost health care services will be eligible under this program.
202. IMMUNITY UNDER ARKANSAS VOLUNTEER IMMUNITY ACT FOR HEALTHCARE PROFESSIONALS
(a) A Health Care Professional who renders
Volunteer Health Care Services to any person at any Free or Low-Cost Health
Care Clinic registered by the State Board of Health, under Section 201, shall
not be liable for any civil damages for any act or omission resulting from the
rendering of the healthcare services unless the act or omission was the result
of the healthcare professional's gross negligence or willful
misconduct.
(b) The board and its
members and the department and its agents and employees are exempt and immune
from liability for any claims or damages when performing their duties under
this section.
203. REQUIRED NOTICE TO PERSONS RECEIVING HEALTH CARE SERVICES AT FREE OR LOW-COST HEALTH CARE CLINICS
(a) Any
persons who receive health care services from a Free or Low-Cost Health Care
Clinic must:
(1) Have been fully informed
before any treatment by the healthcare professional providing the health care
services or by the staff of the healthcare clinic of the immunity from civil
suit provisions of this section; and
(2) Have acknowledged that fact in writing on
a form approved or designated by the Department of Health.
(b) The board and its members and the
department and its agents and employees are exempt and immune from liability
for any claims or damages when performing their duties under this
section.
300. REGISTRATION UNDER THE VOLUNTEER HEALTH CARE ACT
301. REGISTRATION PROCESS FOR HEALTHCARE PROVIDERS
(a) Any clinic
wishing to register as a healthcare provider under the Volunteer Health Care
Act will be responsible for completing an application with the Arkansas
Department of Health. An application for registration as a healthcare provider
shall include but not be limited to the following:
(1) Specific location of the clinic to
include street address and city;
(2) A statement indicating that the mission
of the clinic is to provide free or low-cost services;
(3) A list of all medical professionals and
their specialties currently providing volunteer services in the
clinic;
(4) A statement indicating
medical professionals delivering services in the clinic are not receiving any
financial or other compensation from the clinic and are acting on a voluntary
basis;
(5) A statement on file that
all medical professionals providing services in the clinic have a current
professional license or are students under supervision of a person who is
licensed in the health care profession for which the student is seeking a
degree, a license, or a certification; and
(6) A copy of the clinic's policy for
notifying patients that the medical professional is rendering voluntary
healthcare services and that he/she is immune from civil suit. This policy must
be in language understood by the patient.
(b) The application must be returned to the
Arkansas Department of Health. An application meeting the requirements of these
Rules will be approved for a period not to exceed three years.
302. REGISTRATION PROCESS FOR MEDICAL PROFESSIONALS
(a) Any
medical professional wishing to provide services as a volunteer shall register
with the Arkansas Department of Health by providing:
(1) A completed application;
(2) A statement indicating that the medical
professional's intent is to provide free or low-cost services;
(3) Verification that the medical
professional is not receiving insurance payments for services rendered, if the
medical professional is registering as a healthcare professional for the
purposes of Ark. Code Ann. §
16-6-201;
(4) A copy of the medical professional's
current professional license, or if a student, a copy of certification the
student is currently enrolled in a school/training for which the student is
seeking a degree, a license, or a certification;
(5) A statement on file that, if the medical
professional is a student, the student is under supervision of a person who is
licensed in the medical profession for which the student is seeking a degree, a
license, or a certification; and
(6) A copy of the medical professional's
policy for notifying patients that the health care professional is rendering
voluntary health care services and that he/she is immune from civil suit. This
policy must be in language understood by the patient.
(b) The application must be returned to the
Arkansas Department of Health. An application meeting the intent of Act 276 of
1997 will be approved for a period not to exceed three years.
400. APPLICABILITY OF THE VOLUNTEER HEALTH CARE ACT
401. CONTRACTS TO PROVIDE VOLUNTEER HEALTH SERVICES
(a) A healthcare
provider or medical professional may enter into a contract with the Department
of Health or governmental contractor to deliver volunteer health services to
eligible low-income patients.
(b) A
healthcare provider or medical professional that enters into a contract as
described in subdivision (a)(1) of this section shall be an agent of the state
with sovereign immunity while the healthcare provider or medical professional
is acting within the scope of duties under the contract as described in this
section.
(c) A governmental
contractor that is also a healthcare provider is not required to enter into a
contract under this subchapter with respect to the healthcare services
delivered by employees of the governmental contractor.
(d) The contract shall:
(1) Apply only to volunteer healthcare
services delivered by the healthcare provider or medical professional to
low-income patients who are eligible to receive healthcare services;
(2) Include all employees of the healthcare
provider; and,
(3) State that:
(A) The healthcare provider or medical
professional has sovereign immunity and may not be named as a defendant in an
action arising due to medical care or treatment provided within the scope of
the contract;
(B) If a patient
treated by the healthcare provider or medical professional is ineligible for
services, the healthcare provider or medical professional shall still have
sovereign immunity and may not be named as a defendant in an action arising due
to medical care or treatment provided;
(C) The department or the governmental
contractor has the right to:
(i) Dismiss or
terminate any healthcare provider or medical professional employed under the
contract; and
(ii) Terminate the
contract with a healthcare provider or medical professional with appropriate
cause. At least five (5) business days before the termination date of a
contract, the department or governmental contractor shall provide the
healthcare provider or medical professional with written notice of intent to
terminate the contract and reasons for the decision; and
(iii) Access the records of any patient
served by the healthcare provider or medical professional under the
contract.
402. REPORTING ADVERSE INCIDENTS
(a) The healthcare provider or medical
professional shall report any adverse incidents and information on treatment
outcomes to the department or governmental contractor if pertaining to a
patient treated under the contract.
(b) The healthcare provider or medical
professional shall also report the adverse incident to the appropriate
licensing body to determine whether the adverse incident involves conduct
subject to disciplinary action.
(c)
Patient medical records and identifying information contained in the adverse
incident report shall be confidential and not subject to the Freedom of
Information Act of 1967, §
25-19-101 et seq.
403. PATIENT SELECTION, REFERRALS, AND EMERGENCY CARE
(a) The
Department, governmental contractor, healthcare provider, or medical provider
may make patient selection and initial referrals.
(b) If emergency care is required, the
patient shall be referred within forty-eight (48) hours after the latter of the
time when treatment commences or the patient has the mental capacity to consent
to treatments.
404. REPORTING TO THE ARKANSAS DEPARTMENT OF HEALTH
(a) Annually, the healthcare provider or
medical professional shall report the following information to the Department:
(1) A summary of the efficacy of access and
treatment outcomes;
(2) Statistics
for claims pending and claims paid;
(3) The amount of defense and handling costs
associated with all claims brought against healthcare providers or medical
professionals by the healthcare provider or medical professional working under
the Volunteer Healthcare Program;
(4) The operation hours of the healthcare
provider or medical professional;
(5) The number of patient visits by the
healthcare provider or medical professional working under the Volunteer
Healthcare Program; and
(6) The
value of healthcare-related goods and services provided by the healthcare
provider or medical professional working under the Volunteer Healthcare
Program.
405. CONTINUING EDUCATION CREDIT
(a) A
medical professional may fulfill one (1) hour of continuing education credit
with the performance of eight (8) hours of volunteer services under the
Volunteer Healthcare Program.
(b) A
medical professional shall not obtain more than thirty-two (32) hours of
credits as described in subsection (a) of this section in a licensing
period.
406. NOTICE OF AGENCY RELATIONSHIP
(a)
The healthcare provider or medical professional shall provide written notice to
each patient, parent of the patient, or legal guardian of the patient served
under a contract described in Section 401.
(b) The written notice shall:
(1) Be acknowledged in writing by the
patient, the parent of the patient, or the legal guardian of the patient;
and
(2) Contain information that:
(A) The healthcare provider or medical
professional is an agent of the state; and
(B) The exclusive remedy for damage or injury
suffered as a result of any act or omission by the healthcare provider or
medical professional acting within the scope of duties under a contract
described in this subchapter is to file a claim in the Arkansas State Claims
Commission.
(c) The healthcare provider or medical
professional may comply with the requirements of subdivisions (b)(2)(A) and
(b)(2)(B) of this section by posting the notice in a conspicuous place within
the place of business of the healthcare provider or medical
professional.
407. MALPRACTICE LITIGATION COSTS
(a)
A governmental contractor is responsible for costs and attorney's fees for
malpractice litigation arising out of healthcare services delivered under a
contract brought to the Arkansas State Claims Commission.
500. REGISTRATION FOR VOLUNTEER SERVICES BY RETIRED PHYSICIANS AND SURGEONS
501. REGISTRATION OF RETIRED PHYSICIANS AND SURGEONS
(a) Any retired physicians
and surgeons wishing to provide Volunteer Healthcare Services shall register
with the Arkansas Department of Health by providing:
(1) A completed application;
(2) A statement indicating the Free or
Low-Cost Health Care Clinic where the retired physician will be providing
Volunteer Healthcare Services;
(3)
A statement indicating that the retired physicians and surgeons' intent is to
provide free or low-cost services;
(4) Verification that the Free or Low-Cost
Health Care Clinic is not receiving insurance payments for services
rendered;
(5) A copy of the medical
professional's current professional license; and
(6) A copy of the medical professional's
policy for notifying patients that the health care professional is rendering
voluntary health care services and that he/she is immune from civil suit. This
policy must be in language understood by the patient.
(b) The application must be returned to the
Arkansas Department of Health. An application meeting the intent of Ark. Code
Ann. § 17-95-106 will be approved for a
period not to exceed three years.
502. IMMUNITY FROM LIABILITY FOR RETIRED PHYSICIANS AND SURGEONS
(a)
Retired physicians and surgeons who are licensed to practice medicine by the
Arkansas State Medical Board under the laws of the State of Arkansas who render
Volunteer Healthcare Services and registered under these Rules shall not be
liable for any civil damages for any act or omission resulting from the
rendering of such medical services, unless the action or omission was the
result of the retired physicians or surgeons' gross negligence or willful
misconduct.
(b) The Volunteer
Healthcare Services provided by the retired physician or surgeon must be at a
Free or Low-Cost Health Care Clinic registered with the Department of Health as
provided in these rules.
503. REQUIRED NOTICE TO PERSONS RECEIVING VOLUNTEER HEALTH CARE SERVICES FROM A RETIRED PHYSICIAN OR SURGEON
(a) Any persons who receive
Volunteer Healthcare Services at a Free or Low-Cost Health Care Clinic from a
retired physician or surgeon must:
(1) Have
been fully informed before any treatment by the retired physician or surgeon
providing the health care services or by the staff of the healthcare clinic of
the immunity from civil suit provisions of this section; and
(2) Have acknowledged that fact in writing on
a form approved or designated by the Department of Health.
(b) The board and its members and the
department and its agents and employees are exempt and immune from liability
for any claims or damages when performing their duties under this
section.
600. MISCELLANEOUS PROVISIONS
601. SEVERABILITY
(a) If any provision of these Rules or the
application thereof to any person or circumstances is held invalid, such
invalidity shall not affect other provisions or applications of these Rules
which can give effect without the invalid provisions or applications, and to
this end, the provisions herein are declared severable.
602. REPEAL
(a) All rules and parts of rules in conflict
herewith are hereby repealed.
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