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Act 311 of 1975

An Act to Establish a Program for the Quality Care, Treatment and Rehabilitation of Persons Suffering From Congenital or Acquired Spinal Cord Injury or Damage; to Establish a State Spinal Cord Commission to Administer Said Program; to Authorize the Cooperative Development of an Arkansas Spinal Cord Treatment Center and System; and for Other Purposes.

Be It Enacted by the General Assembly of the State of Arkansas:

SECTION 1. LEGISLATIVE FINDINGS AND PURPOSES. It is hereby declared and found that a major problem facing medicine and the public health and welfare is the absence of an adequate program to assist in the treatment and rehabilitation of persons suffering from congenital or acquired spinal cord dysfunction. It has been found that no fewer than 1,100 Arkansas residents presently suffer from spinal cord injury or damage, and it is estimated that at least 120 Arkansans experience serious injury or congenital dysfunction of the spinal cord annually. Furthermore, it has been found that a fully coordinated approach to the early recognition, the emergency care and transportation, the definitive treatment and rehabilitation and to the long-term management direction and support of such persons is presently lacking, and yet is essential to guaranteeing these patients the best possible opportunity to minimize mortality, morbidity, and permanent disability. It is further recognized that the enormous cost for medical services, hospitalization, and rehabilitative care of spinal cord injured persons makes it extremely difficult, and often financially impossible for persons of moderate or modest means to secure adequate medical and rehabilitative services, and in most cases, such services are financially possible only by the very wealthy, if at all. Therefore, to guarantee the best possible opportunity for minimizing the mortality, morbidity, and permanent disability of persons due to spinal cord injury or dysfunction it is essential that the State develop a program to: (1) provide for complete identification and visible integration of the numerous complex funding mechanisms which are applicable to the needs of a particular individual at each overlapping stage of treatment and rehabilitation, and to provide financial assistance when necessary to fill a specific identified gap in funding a portion of the coordinated treatment and rehabilitation plan of a specified patient, when the patient's own financial resources are insufficient to meet such requirements; (2) to authorize the development and operation of an Arkansas Spinal Cord Treatment Center and System, which will integrate present treatment and rehabilitative capabilities, and develop additional service capabilities as necessary to guarantee the availability of continuously current and evolving new processes in state of the art treatment and rehabilitative services to all spinal cord disabled Arkansas; and (3) provide for full coordination of treatment and rehabilitative efforts from problem recognition through progressive rehabilitation and for as long as a need for these specialized services shall exist.

SECTION 2. ESTABLISHMENT OF COMMISSION-SELECTION OF MEMBERS. There is hereby established a State Spinal Cord Commission; hereinafter referred to as "the Commission," to consist of nine (9) members. Eight members of the Commission shall be appointed by the Governor as follows:

  1. a. Four members shall be professionals in this State, who have demonstrated interest in and are knowledgeable of all phases of spinal cord care, treatment, and rehabilitation, at least two (2) of whom shall be licensed physicians in this State. In the event a Department of Rehabilitation Medicine (DRM) is established within the University of Arkansas Medical Center, the Chairman of such Department or his designated representative shall automatically be a member of the Commission, occupying continuously one of the four positions provided for in this subsection.

  2. b. Four members shall be appointed form the public at large, who are either spinal cord injured victims themselves or members of the immediate family of a spinal cord injured victim, or who are persons with special knowledge of and experience with spinal cord injury and dysfunction, and who have demonstrated active involvement and interest in the fight against death and disability from spinal cord injury and dysfunction.

The Director of the Department of Social and Rehabilitative Services of the State of Arkansas or his designated representative shall be a member of the Commission. The Commissioner of the Arkansas Rehabilitation Services Division of the Department of Social and Rehabilitative Services shall serve as secretary of the Commission, but shall not be a member of, or have a vote on, the Commission and shall serve as disbursing officer of funds appropriated to the Commission, upon the approval of all such expenditures by the Chairman of the Commission.

The appointed members of the Commission provided for in subsections (a) and (b) above shall be appointed for eight-year terms. Provided, that of the initial members appointed to the Commission the Governor shall designate their respective terms in order that the term of one member shall expire on January 14, 1976 and the term of one member shall expire on January 14 of each year thereafter. Successive members shall be appointed for eight-year terms of office. Provided further, that in the initial establishment of the Commission, if there has not been established a DRM within the University of Arkansas Medical Center, and said DRM is subsequently established, the Chairman of said Department shall immediately become a member of the Commission and shall constitute an additional member of the Commission until such time as the first vacancy shall occur in a position held by a member appointed pursuant to subsection (a) above, and upon the occurrence of such vacancy, the membership of the Commission shall reduce to the membership as intended in subsection (a) above.

Members of the Commission shall serve until their successors are appointed and qualified. In the event vacancy occurs to the Commission due to death, resignation, or other cause, said vacancy shall be filled by appointment of the Governor by a person eligible for initial appointment as hereinabove provided for, for the remainder of the unexpired portion of the term of such member.

All appointed members of the Commission shall be confirmed by the Senate, as provided by law.

SECTION 3. OFFICERS AND MEETINGS OF THE COMMISSION. The Commission shall annually elect one of its members as Chairman and one of its members as Vice Chairman, and such other officers as the Commission deems necessary. The Commission shall meet at least once each calendar quarter and at such other times as may be designated by the Commission's rules, or upon call by the Chairman or by the written request of any four members. Members of the Commission shall serve without pay, but shall be reimbursed from Commission funds, if available, for reasonable and necessary expenses incurred in attending to Commission business, in the same manner and in accordance with the same conditions, restrictions, and limitations as are applicable to employees of the State. Members of the Commission shall qualify by taking the oath of office as prescribed by law.

SECTION 4. POWERS AND DUTIES OF THE COMMISSION. The Commission shall have the following functions, powers, and duties:

  1. a. to identify and cooperate with existing agencies, organizations, and individuals offering services to the spinal cord injured/spina bifida patient of the establishment and integration of a State-wide system of treatment, rehabilitation, counselling, and social services by; means of entering into cooperative agreement with such agencies, organizations, and individuals. Such programs shall be designed and administered as to:
    1. 1. provide for coordinated and integrated development and continued review of a full treatment and rehabilitation plan for each qualified applicant patient;

    2. 2. identify all possible and existing funding sources for each type of service identified in the treatment plan for which a qualified patient may be eligible, and assist such patient in obtaining funding assistance for which he is eligible from existing sources;

    3. 3. assess the patient's financial ability to pay for needed services identified in the treatment plan for which no other funding sources are available;

    4. 4. provide financial assistance for persons unable to pay for such services, including special equipment without causing unjust and unusual hardship to such person or his immediate family, including but not limited to, a drastic lowering of the standard of living;

    5. 5. identify service needs which cannot be adequately met by existing resources;

    6. 6. provide for increased accountability by documenting the full range of fiscal resources being invested from the various funding sources toward the achievement of each patient's service plan objectives; and

    7. 7. provide an annual report to the Governor, to the General Assembly, and to the public documenting areas of success, unresolved problems, and overall cost/benefit analyses of expenditures from the various sources;

  2. b. to develop or cause to be developed an Arkansas Spinal Cord Treatment Center and System to serve the entire State through the provision of such direct and indirect services as may be identified and documented as provided for in subsection (a) of this Section. Such Center and System may provide such services as specialized emergency and acute care, specialized emergency transfer services, specialized diagnostic and prescriptive services, specialized rehabilitative services, family education and home care outreach services, coordinative services, continuing educational services for physicians and other health professionals and paraprofessionals who deal with the spinal cord patient, and such other services as are deemed necessary and appropriate by the Commission.

  1. At such time as an Arkansas Spinal Cord Treatment Center is established, the Commission shall serve as its Board of Directors and may either directly administer the operation of the Center, or may enter into contractual agreements with existing institutions for facilities, staffing, and administrative services, or such other services as the Commission deems appropriate. Provided, that until an Arkansas Spinal Cord Treatment Center is established, or after such Center is established, the Commission may, whenever the Commission determines it to be in the best interest of a spinal cord injured person, contract and/or pay for services provided by other institutions. It is the intent of this Act that the Commission have broad discretion In providing or obtaining for spinal cord injured patients a complete level of services which the Commission deems to be in the best interest of said patient, as set forth in this Act.

  2. c. to work with all appropriate agencies, organization, and individuals throughout the State, to develop a fully integrated State-wide network of coordinated services for spinal cord patients covering all needed services from the detection of spinal cord injuries or congenital conditions through the related phases of emergency care and transfer, acute and definitive care, and rehabilitative and follow-up care; and to thus affect a measured reduction in spinal cord related morbidity and mortality, long-term disability and long-term maintenance system expenditures of public funds;

  3. d. to provide special expert consultation and services to cooperating and participating agencies, institutions and individuals including appropriate elements of the Arkansas Emergency Medical Services (EMS) System on the emergency care and transportation of spinal cord injured persons and to other agencies, institutions and individuals responsible for delivery of professional medical and health sciences, education and training necessary for providing appropriate progressive and evolving specialized programs of treatment of service to spinal cord injured/spina bifida patients;

  4. e. to develop standards for determining eligibility for assistance in defraying the cost of care and treatment of spinal cord patients under this program; and

  5. f. to accept gifts, grants, and donations from private sources, from municipal and county governments, from the State and from the Federal government, to be used for the purposes of the Act in defraying costs incurred by persons suffering from spinal cord disability who are unable to meet the total cost of treatment and rehabilitation, and to promote the development of specialized service capability found to be needed but not available.

SECTION 5. FISCAL RESOURCE ADVISORY COMMITTEE. To assist the Commission in developing coordinated, fully integrated, and accountable funding packages for implementing treatment plans for individual patients, the Governor shall appoint a Fiscal Resource Advisory Committee consisting of local , State, and Federal employees, and such other persons directly involved and expert in the administration of programs, both public and private, which potentially or actually provide direct or indirect financial assistance to any or all spinal cord patients at any phase of care. The Commission, acting through its Chairman, shall cooperate with the Governor in the appointment of members to the Fiscal Resource Advisory Committee by recommending to the Governor, from time to time, the names of agencies and individuals to be considered by the Governor for appointment to the Committee. The members of the Committee shall serve at the pleasure of the Commission. The Committee shall meet at the call of the Chairman of the Commission.

SECTION 6. DISBURSEMENT OF FUNDS. The Commissioner of the Arkansas Rehabilitation Services Division of the Department of Social and Rehabilitative Services shall be the disbursing officer of funds appropriated by the General Assembly or of other funds made available to the Commission, upon approval of said expenditures by the Chairman of the Commission. In addition, the Director of the Rehabilitative Services shall assist the Commission by offering techincal advice or assistance when requested by the Commission, and shall assist the Commission in preparing budgets and other reports for submission to the Governor and to the General Assembly. The Commissioner of the Arkansas Rehabilitation Services Division of the Department of Social And Rehabilitative Services shall be governed by the policies, rules and regulations, and procedures promulgated by the Commission in disbursing funds appropriated or otherwise made available to the Commission, but all such expenditures shall be approved by the Chairman of the Commission by affixing his signature to all vouchers for proposed expenditures.

SECTION 7. REPEALER. All laws and parts of laws in conflict with this Act are hereby repealed.

SECTION 8. SEVERABILITY. If any provision of this Act or the application thereof to any person or circumstance is held invalid, such invalidity shall not affect other provisions or applications of the Act which can be given effect without the invalid provision or application, and to this end the provisions of this Act are declared to be severable.

SECTION 9. EMERGENCY. It is hereby found and determined by the General Assembly that legislative findings and purposes set forth in Section 1 of this Act document the immediate need for the establishment of an adequate program to assist in the treatment and rehabilitation of persons suffering from congenital and acquired spinal cord dysfunctions, and that the immediate passage of this Act is necessary to enable the Governor to establish a State Spinal Cord Commission to immediately commence the development, implementation, and operation of a spinal cord treatment program in this State for deserving and qualified citizens of this State. Therefore, an emergency is hereby declared to exist and this Act being necessary for the immediate preservation of the public peace, health, and safety, shall be in full force and effect from and after the date of its passage and approval.

APPROVED: March 4,1975