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SB 20

AN ACT FOR THE DEPARTMENT OF HUMAN SERVICES - DIVISION OF MEDICAL SERVICES APPROPRIATION FOR THE 2026-2027 FISCAL YEAR.

2026 Fiscal Session

Funds up to 2026-2027 for Arkansas DHS-DMS to operate, pay staff, and broadly fund Medicaid grants, with rate methodology rules, targeted waivers, and enrollment advertising restri

Notification that SB20 is now Act 132
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WeVote Research Nonpartisan
Bill Summary · SB 20

Summary of SB 20 (2026F) — Arkansas

Purpose

SB 20 seeks an appropriation for the Department of Human Services (DHS) — Division of Medical Services (DMS) for the fiscal year ending June 30, 2027. It outlines staffing, operating, and grant expenditures, along with special language on Medicaid rate methodologies, targeted programs, and reporting requirements. The bill also includes several policy provisions affecting how funds may be used, especially regarding health insurance marketplace activities and targeted waivers.

Key Provisions and Provisions by Section

Section 1 — Regular Salaries (Operations)

  • Establishes the maximum number of regular state employees for DMS in 2026-2027 (up to 91 positions).
  • Provides a detailed table of job titles, counts, and maximum salary grades (e.g., DHS Division Administrator, Health Program Supervisors, Pharmacists, Registered Nurses, IT staff, etc.).
  • Categories cover administration, program operations, clinical roles, IT, procurement, accounting, and support staff.

Section 2 — Extra Help (Operations)

  • Authorizes up to 10 part-time or temporary employees for the 2026-2027 fiscal year, with pay rates in line with the Uniform Classification and Compensation Act.

Section 3 — Appropriation – Operations

  • Regular Salaries: $6,483,248
  • Extra Help: $201,892
  • Personal Services Matching: $2,227,427
  • Overtime: $2,241
  • Maintenance & General Operations:
    • Operating Expenses: $1,713,290
    • Conference & Travel: $40,099
    • Professional Fees: $800,000
    • Data Processing Services: $1,299,600
  • Total Operations Appropriation: $12,767,797

Section 4 — Appropriation – Grants

  • Grants to be funded from DHS Grant Funds for the 2026-2027 year, including:
    • ARKids B Program: $167,661,480
    • Hospital and Medical Services: $8,336,005,717
    • Prescription Drugs: $625,636,547
    • Private Nursing Home Care: $1,048,963,434
    • Child and Family Life Institute: $2,100,000
    • Infant Infirmary: $327,608
    • Public Nursing Home Care: $217,529,350
  • Total Grants: $10,398,224,136

Section 5 — Nursing Home Closure Costs

  • Appropriates $4,500,000 for relocation costs of residents, maintenance pending deficiencies/closure, and reimbursement of residents’ personal funds losses related to nursing home issues, funded from the Long-Term Care Trust Fund.

Section 6 — Long-Term Care Facility Receivership

  • Allocates $100,000 for expenses of long-term care facility receivers under the DHS Division of Medical Services.

Section 7 — Nursing Home Quality Grants

  • Allocates $4,000,000 for Nursing Home Quality Grants and related aid, funded from the Long-Term Care Trust Fund.

Section 8 — Special Language: Medical Services – General Medicaid Rate Methodology

  • DHS DMS must set rates using CMS-approved methodologies and may adjust rates for good cause (e.g., cheaper providers, equal quality care, changes in tech/process, or economic downturn).
  • Annual adjustments based on CMS Market Basket Index, unless the state budget blocks increases.
  • Any proposed rate changes must receive prior approval from the Legislative Council or Joint Budget Committee.
  • Establishes a sunset for this provision (effective July 1, 2026 to June 30, 2027).

Section 9 — Special Language: DHS Grant Fund Use (Children’s Hospital)

  • DHS may retain up to $2,100,000 within the Child and Family Life Institute line item to match federal funds for supplemental Medicaid payments to Arkansas Children’s Hospital.
  • Funds retained are not to be transferred back to General Revenue.

Section 10 — Special Language: Arkansas Health and Opportunity for Me Marketplace Restrictions

  • Limits DHS’s use of appropriated funds for promoting enrollment in the Arkansas Health Insurance Marketplace or Arkansas Health and Opportunity for Me.
  • Prohibits advertising campaigns (TV, radio, billboards, print, online) funded by this act, with limited exceptions for direct communications to licensed agents, solicited communications, informational materials, or a dedicated enrollment website.
  • Prohibits accepting funds (including federal funds) to promote marketplace enrollment, with specified exceptions (counselors at health-related institutions may be funded).
  • Excludes certain regulatory/training responsibilities from the prohibition.
  • Sunsets this restriction on June 30, 2027.
  • Also prohibits reallocating funds to activities banned by this section.

Section 11 — Special Language: Medicaid Waiver Funds for Community and Employment Supports

  • Sets aside $37,600,000 in the DHS Grants Fund (subfund) for home and community-based services for individuals with intellectual and developmental disabilities under the Community and Employment Supports Medicaid Waiver (or successor).
  • Unexpended balances at end of FY2026 can be carried forward to FY2027 for the same purpose.
  • Effective July 1, 2025 to June 30, 2027.

Section 12 — Special Language: Medicaid Program Trust Fund Reporting

  • Requires monthly reports on the Arkansas Medicaid Program Trust Fund balance and distributions to Legislative Council PEER Subcommittee, detailing distributions, dates, fund codes, line items, and purposes.
  • Effective July 1, 2025 to June 30, 2027.

Section 13 — Compliance with Other Laws

  • Disbursement must comply with all applicable state procurement, budgetary, and fiscal control laws and DFA regulations.

Section 14 — Legislative Intent

  • Affirms that authorization and funding align with the budget process and legislative recommendations.

Section 15 — Emergency Clause

  • Declares an emergency to ensure immediate effectiveness of the act on July 1, 2026, enabling uninterrupted operation.

Affected Entities and Impacts

  • Department of Human Services (DHS), Division of Medical Services (DMS): Primary recipient and administrator of funds for operations, grants, nursing home-related costs, and Medicaid waivers.
  • Arkansas Medicaid Program: Rates, methodologies, and trust fund distributions affect provider payments and overall program funding.
  • Arkansas Children’s Hospital: Potentially receives matched funds via the Child and Family Life Institute for supplemental Medicaid payments.
  • Nursing homes and long-term care facilities: Funding for relocation, receivership, and quality grants; potential changes to nursing home waivers and quality initiatives.
  • Health insurance marketplace activities: Restrictions on DHS-funded marketing and enrollment activities (through 2027), with limited permissible communications.
  • Intellectual/Developmental Disabilities community: Dedicated waiver funds for home and community-based supports.

Timelines and Process

  • Fiscal year: July 1, 2026 to June 30, 2027 (with several sections referencing 2027).
  • Rate methodologies subject to CMS-approved processes, with annual adjustments contingent on budget appropriations.
  • Some special provisions expire or sunset on June 30, 2027 (Sections 8, 10, 11, 12).
  • Emergency clause makes the act effective beginning July 1, 2026, to ensure readiness for the 2026-2027 fiscal year.

Overall Effect

SB 20 formalizes the DHS-DMS 2026-2027 funding package, detailing personnel ceilings, operating and grant expenditures, and targeted special appropriations. It imposes constraints on marketing activities for health insurance enrollment, while preserving flexibility for rate adjustments under CMS methodologies and for targeted Medicaid waivers and long-term care initiatives. The act emphasizes transparency (through mandated reporting) and provides for emergency effectiveness to maintain continuity of essential health services.

Compiled from official sources — confirm details with the bill’s official record.

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