Representatives of behavioral health providers told a subcommittee of the Arkansas House Public Health, Welfare and Labor Committee on Monday, Oct. 26, that the state lacks adequate intermediate-level mental health services for children, contributing to unnecessary hospital admissions.
Advocates describe gaps between weekly therapy and inpatient care
Jaymie Hopkins, an executive at Pinnacle Pointe Behavioral Healthcare System who oversees 11 outpatient clinics in Arkansas, testified that many children need more intensive services than weekly therapy can provide but do not meet criteria for inpatient hospitalization. Pinnacle Pointe also operates an acute inpatient unit and a long-term sub-acute facility in Little Rock, Hopkins said.
“We should not have to wait until a child requires hospitalization or residential treatment to provide them with more intensive treatment,” Hopkins said.
Hopkins told lawmakers that reductions in behavioral health paraprofessionals at Pinnacle Pointe outpatient clinics in recent years have left some children without appropriate options. As a result, she said, youth are sometimes routed directly to hospitals instead of receiving intermediate outpatient care.
“They go straight into the hospital, rather than being able to access these intermediate levels of care,” Hopkins said.
Hopkins and other witnesses noted that in-home services and community reintegration programs exist in Arkansas but can be difficult to access in parts of the state, particularly in rural counties. She added that the system sometimes requires families to enter higher levels of care before intensive outpatient support becomes available.
Stakeholders also raised concerns about coverage under the state’s Medicaid managed-care arrangements for Arkansans with complex behavioral health needs. Provider-Led Arkansas Shared Savings Entities, known as PASSEs, serve Medicaid enrollees with significant behavioral health or intellectual and developmental disability needs, but Hopkins said PASSEs do not cover intensive outpatient programs for children.
Lawmakers hear potential solutions ahead of 2027 session
With the 2027 legislative session less than three months away, witnesses and committee members discussed possible policy changes, workforce incentives and adjustments to Medicaid-covered services that could expand access to intermediate levels of care for youth. Hopkins urged changes that would allow more front-end support rather than waiting until hospitalization is necessary.
Committee members heard testimony from the Arkansas Council for Behavioral Health, which highlighted workforce shortages and service gaps that they say are especially acute outside urban centers. No bill was introduced during the meeting; lawmakers signaled the testimony would inform discussions before the upcoming session.
The hearing did not produce immediate legislative action. Committee staff and members indicated they would review testimony and provider recommendations as they consider proposals for the 2027 session.
- What witnesses said: Providers called for more intermediate outpatient programs, better PASSE coverage, and steps to rebuild the behavioral health paraprofessional workforce.
- Where services fall short: Gaps exist between weekly therapy and hospitalization, with access problems more pronounced in rural areas.
- Next steps: Lawmakers heard testimony to guide potential policy and budget proposals before the 2027 legislative session.
