Arkansas Department of Human Services v. Lori Rawls

Cite as 2026 Ark. App. 284
ARKANSAS COURT OF APPEALS
DIVISION IV
No. CV-25-282

Opinion Delivered May 6, 2026

APPEAL FROM THE PHILLIPS
ARKANSAS DEPARTMENT OF
COUNTY CIRCUIT COURT
HUMAN SERVICES
[NO. 54CV-24-148]
APPELLANT

HONORABLE DANNY GLOVER,
V.
JUDGE

LORI RAWLS DISMISSED WITHOUT PREJUDICE
APPELLEE

CINDY GRACE THYER, Judge

The Arkansas Department of Human Services (DHS) appeals an order of the Phillips

County Circuit Court remanding the case back to DHS, Office of Appeals and Hearings, for

an in-person hearing and to allow for the presentation of additional evidence. We dismiss

for lack of a final, appealable order.

Appellee Lori Rawls is the mother and guardian of Jackson Rawls, a twenty-one-year-

old who suffers from Baraitser-Winter syndrome, hypertonia, hyperextension of the wrists,

flat feet, and scoliosis as well as intellectual and developmental disabilities. She applied on

Jackson’s behalf for the ARChoices waiver program to receive in-home care.1

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ARChoices in Homecare is a Medicaid program that provides home and community-
based services for adults ages twenty-one through sixty-four with a physical disability, and for
seniors age sixty-five or older. Arkansas Department of Human Services, ARChoices in
To determine Jackson’s eligibility in the program, DHS obtained an assessment by a

registered nurse with Optum Government Solutions. That assessment found that Jackson

had limitations in all three aspects of daily living—eating, transferring/locomotion, and

toileting—and assigned him a Tier Two rating, indicating that he might meet the functional

eligibility requirements of ARChoices.

On February 22, 2024, DHS denied Rawls’s request for ARChoices coverage, stating

that Jackson was ineligible. According to the ARChoices waiver program manual, section

212.100(c), in order for a participant to qualify for an intermediate level of care, the

participant must be totally dependent or require extensive assistance from another person in

two of the three areas of mobility, feeding, and toileting. While Jackson’s assessment showed

that he had limitations in all three areas, DHS noted that the assessment indicated he could

eat and transfer without hands-on assistance and required only limited assistance while

toileting.

Rawls appealed the denial and requested a hearing.

Homecare, https://humanservices.arkansas.gov/divisions-shared-services/aging-adult-
behavioral-health-services/find-home-community-based-services-for-adults-seniors/archoices-
in-homecare (archived at https://perma.cc/YJ9Y-T29T) (date last accessed 04/29/2026).
The program is designed to prevent nursing home admissions of those at risk. American
Council on Aging, Arkansas Medicaid’s ARChoices in
Homecare/Independent Choices Program, https://www.medicaidplanningassistance.org/arkans
as-archoices-in-homecare (archived at https://perma.cc/7TAT-885T) (date last accessed
04/29/2026).

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An administrative hearing was held telephonically on May 7. Rawls appeared pro se;

DHS appeared through counsel.

Rawls testified that Jackson was twenty-one years old and had one year left in school,

where he receives occupational therapy due to his disabilities. She stated that Jackson suffers

from Baraitser-Winter syndrome, which affects him mentally and physically. He also has a

total spine fusion, which limits his ability to bend and twist. She stated that he cannot bathe

himself, and while he can feed himself, his meals must be prepared for him. She testified

that sometimes she has to help him finish his meals because he cannot get food around the

rim. She also stated that, while he can toilet himself, he cannot unzip or unbutton his pants,

and he cannot clean himself. As for mobility, she stated that he is mobile, can move from a

bed to a chair, and can walk around in the house. She says that his syndrome also affects his

vision, noting that he ran into a wall during his assessment.

Rochelle Fair-Bailey, the registered nurse who conducted Jackson’s assessment, also

testified at the hearing. She stated that she conducted the assessment and assessed him at

Tier Two, using “afria (phonetic)” and information by provided by Rawls.

Deanna Price, a registered nurse with the Division of County Operations in the

Medical Determination Department, testified regarding DHS’s denial. She stated that DHS

does not rely on the tier level determined by Optum but instead bases its determination on

its own review of the assessment. She stated that a nurse in her office had reviewed the

Optum assessment and had determined that Jackson was limited only in toileting. After

hearing Rawls’s testimony at the hearing, her decision would not change. She testified:

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Well, I’m – I’m looking at the assessment right now and ED was set up
independent. Toileting was limited. Transfers, he didn’t need any assistance, and
under mobility, the Optum assessment says limited, but under other challenges
getting around the home, it says, caregiver states client has issues with his back and
feet and balance issues and poor navigation. He needs supervision and non-
weightbearing hands-on help to safely go up and down the stairs in the home, but
client only goes up and downs the stairs in the home maybe one to two times a month,
and for it to be limited have to be one – I mean, three or more times a week hands-
on assistance. And that’s why that’s not limited.

She stated that there was no indication that Jackson suffered from Alzheimer’s or

related dementia; nor did he have any medical condition that required monitoring or

assessment by a licensed medical professional at least once a day. She did state, however, that

Jackson might be eligible for personal-care services.

At the close of the hearing, Rawls informed the court that she would provide the

hearing officer with a copy of Jackson’s Medicaid assessment performed by Dr. Sudhir

Kumar. DHS agreed but requested that the record be kept open so that it had an opportunity

review the document.

The hearing officer issued its decision denying Jackson’s ARChoices application on

May 17. The hearing officer concluded that Jackson did not meet the criteria for a nursing-

home-facility level of care. The hearing officer noted:

In this matter [Jackson] is not functionally disabled in at least two of the
following three activities of daily living of toileting, eating, or
transferring/locomotion. [Jackson] did not need limited or extensive assistance or
total dependence with eating and transferring/locomotion. Furthermore, [Jackson]
does not have a diagnosis of Dementia or Alzheimer’s. [Jackson] does not have a
diagnosed medical condition which requires monitoring or assessment at least once
a day by a licensed medical professional and the condition, if untreated would be life-
threatening.

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As a result, the hearing officer concluded that Jackson had failed to prove that he met the

medical criteria for the nursing home placement/level of care, and therefore, DHS had not

erred in determining that Jackson was ineligible for those services.

Upon receiving the denial, Rawls hired counsel and filed a petition for judicial review

in the Phillips County Circuit Court. The circuit court held a hearing on December 9, and

Jackson was present. At the hearing, Rawls requested the opportunity to present witnesses,

and DHS objected. The court heard arguments of counsel and took the matter under

advisement. Both parties filed briefs in support of their respective positions. As part of her

brief, Rawls filed a copy of the Optum assessment along with four affidavits attesting to

Jackson’s limitations with respect to eating, mobility, and toileting. DHS responded, again

objecting to introduction of any evidence not a part of the administrative agency’s record.

After reviewing the pleadings and the record and after considering the arguments of

counsel, the court entered an order remanding the matter back to the agency for further

proceedings and an in-person hearing. The court stated that, after careful consideration, it

had determined that the record had not been fully developed and that DHS needed to

conduct further review for the following reasons:

First, [Rawls] who spoke on behalf of Jackson at the hearing before the ALJ, is
not a lawyer and is not trained in the presentation of evidence or on the nuances of
law pertaining to the ARChoices waiver program. [Rawls] now has the benefit of
counsel who is better qualified to understand the issues to be adjudicated and is better
qualified to advocate for Jackson. [Rawls’s] counsel is better trained to present
evidence to support Jackson’s limitations and his need for assistance. [Rawls’s]
counsel is also better trained to challenge the findings of DHS and to critique any
investigation conducted by DHS workers or by independent organizations such as
Optum.

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Second, at the hearing conducted by this Court, [Rawls’s] counsel requested
the opportunity to present additional proof. This Court believes that any such proof
should be presented to DHS and the ALJ so that it may be reviewed and become part
of the record prior to consideration by this Court. A remand will allow for additional
proof and further consideration by DHS.

Third, it would be essential in remand for the ALJ to personally observe
Jackson in order to have a full understanding of the context of Jackson’s limitations.
While telephonic hearings afford convenience and efficiency in many instances, they
sometimes cloud or obscure the import of the proof presented. Such is the case here.
A full appreciation of the limitations and needs of Jackson is better realized at an in
person hearing.

The court concluded its order by ordering DHS to conduct the follow-up hearing within 120

days of entry of its order and stated that the case would remain open in the event further

review was necessary.

DHS has appealed this ruling. On appeal, DHS claims (1) that the agency’s decision

was supported by substantial evidence and (2) that the agency’s decision was neither arbitrary

nor capricious. Finally, DHS contends that the circuit court improperly considered

additional evidence in reaching its decision. We cannot reach any of these issues because we

lack a final, appealable order.

A circuit court’s order of remand to an administrative agency for further proceedings

is not a final, appealable order, Olwan v. Ark. Tobacco Control Bd., 2020 Ark. App. 201

(dismissing appeal of circuit court’s order remanding for two new hearings as not final),

because an order to remand is not final and appealable if it directs the agency to complete a

step that is a predicate to the circuit court’s ultimate decision. Ark. Dep’t of Fin. & Admin. v.

Naturalis Health, LLC, 2018 Ark. 224, 549 S.W.3d 901. When this occurs, the circuit court’s

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order contemplates the agency completing the task and the case returning to it for a final

decision. Id.

An order of remand, however, is not always a nonfinal order. The supreme court in

Naturalis, supra, concluded that the circuit court’s order was final in that it nullified the

Medical Marijuana Commission’s decision and remanded to restart the licensing-selection

process, i.e., the circuit court had ruled on the merits.

Here, however, the circuit court’s order is not a ruling on the merits as was the case

in Naturalis; rather, it directs the court to hold another hearing, in person, within 120 days

to take additional evidence on Jackson’s limitations. See, e.g., Rogers v. Wood Mfg., 46 Ark.

App. 43, 877 S.W.2d 94 (1994) (Commission’s order of remand, which neither awarded nor

denied compensation, was a decision on an incidental matter and was, thus, not final and

appealable). It also provides that the case will remain open in the event further review is

needed by the court. Clearly, the court’s order in this case did not decide the rights of the

parties: instead, it contemplated additional action. As such, this case is more similar to Olwan

than Naturalis. Because we lack a final, appealable order, we lack jurisdiction and must

dismiss.

Dismissed without prejudice.

WOOD and BROWN, JJ., agree.

Vincent P. France, Deputy Chief Counsel, Arkansas Department of Human Services,

for appellant.

One brief only.

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