Arkansas provides long-term care resources to seniors through its Department of Human Services, Division of Aging and Adult Services. These agencies administer a variety of programs to assist seniors in long-term care planning. The Division of Aging and Adult Services serves as the focal point for all matters concerning older Arkansans; serves as an effective and visible advocate for the aging population; gives elderly citizens a choice of how and where they receive long-term care services; plans, coordinates, funds and evaluates programs for senior adults.

The Arkansas Choices in Living Resource Center is an Aging and Disability Resource Center (ARDC) that will assist consumers in making informed choices about all of the options and services that may be available. The Resource Center works to minimize confusion and facilitate access to services. Some of the services provided through the center include Options Counseling; In-Home Services like Attendant Care Services and home-delivered meals; Medicaid eligibility; Support groups; Home modifications; Disability resources; Family caregiver assistance; Assistive technology; and how to apply for services. For additional information, you may call 866.801.3435 or email at choicesinliving@arkansas.gov.

Arkansas offers two home-and-community-based (HCBS) Medicaid Waivers for seniors 65 years and older who meet the financial and healthcare requirements under the waiver program.

Medicaid Waiver Programs for Assisted Living and In-Home Care

Arkansas ARChoices in Homecare Medicaid Waiver (ARChoices)

ARChoices is a Medicaid program that includes home and community-based services for adults ages 21 through 64 with a physical disability and seniors age 65 or older. These services can offer help doing everyday activities that you may no longer be able to do for yourself, like bathing, dressing, getting around your home, preparing meals, or doing household chores.

Services

The ARChoices waiver program includes Attendant Car, Home-Delivered Meals, Personal Emergency Response System; Adult Day Services, Adult Day Health Services; Facility-Based Respite Care, In-Home Respite Care; and Environmental Modifications.

Eligibility

  1. Health: Applicants must meet the nursing home level of care as determined by the Office of Long-Term Care.
  2. Financial: If an applicant is not already Medicaid-eligible, the applicant’s income and assets must be below certain limits. For 2022, The applicant’s income must be less than $2,523 (300%, or three times, the Supplemental Security Income allowance) per month and countable resources less than $2,000 for a single person or $3,000 for a couple. If an applicant’s income is too high, then a Miller Trust (also known as a Qualified Income Trust) can allow them to access the benefits by funnelling their income into the trust for the purpose of paying for care. An individual cannot make more income than the total cost of care.

Practical Considerations

Some issues when considering the ARChoices waiver program include whether or not your medical needs are sufficient to qualify for a nursing home level of care. Also, the application will go through your local Area Agency on Aging, and there might be a waitlist for services.

Living Choices Assisted Living Waiver (Living Choices)

Living Choices is a Medicaid program that allows you to live in congregated housing with 24-hour supervision and services that support independence. Living Choices makes assistance available in Level II assisted living facilities. The apartment-style provides an environment that promotes self-direction and personal decision-making, while protecting residents’ health and safety. The Living Choices waiver is great if you are: at risk of nursing home placement, want to return from a nursing home to a more independent setting, and if you need around-the-clock supervision.

Services

Services included in the Living Choices waiver program include Attendant Care, Therapeutic Social and Recreational Activities, Medication oversight (to the extent permitted under state law Medication administration), Periodic nursing evaluations, Limited nursing services, Non-medical transportation, Pharmacist consultant services, Three prescription drugs beyond the Medicaid State Plan Pharmacy Program’s benefit limit.

Eligibility

  1. Health: Generally, applicants must have medical needs that require a nursing home level of care at the intermediate level if there are no waiver options otherwise available. Additional medical criteria for the Living Choices waiver program the applicant must meet include at least one of the following criteria as determined by a licensed medical professional.
    1. The individual is unable to perform either of the following:
      1. (A) At least one of the three activities of daily living (ADL) of transferring/locomotion, eating or toileting without extensive assistance from or total dependence upon another person; or
      2. (B) At least two of the three activities of daily living (ADL) of transferring/locomotion, eating or toileting without limited assistance from another person; or,
    2. The individual has a primary or secondary diagnosis of Alzheimer’s disease or related dementia and is cognitively impaired so as to require substantial supervision from another individual because he or she engages in inappropriate behaviors which pose serious health or safety hazards to himself or others; or,
    3. The individual has 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.
  2. Financial: If an applicant is not already Medicaid-eligible, the applicant’s income and assets must be below certain limits. For 2022, The applicant’s income must be less than $2,523 (300%, or three times, the Supplemental Security Income allowance) per month and countable resources less than $2,000 for a single person or $3,000 for a couple. If an applicant’s income is too high, then a Miller Trust (also known as a Qualified Income Trust) can allow them to access the benefits by funnelling their income into the trust for the purpose of paying for care. An individual cannot make more income than the total cost of care. When a married individual applies and the spouse does not, a portion of the couple’s resources can be protected for the ineligible spouse and not counted toward the applicant’s resource limit. The following spousal resource rules apply: If total resources are under $24,180, the ineligible spouse gets all of the resources. If total resources are $24,180 to $48,360.00, the ineligible spouse gets $24,180. The ineligible spouse gets one-half if the total resources are $48,360 to $241,800.00. If total resources are over $241,800.00, the ineligible spouse gets $120,900.00 ( effective January 1, 2017).

Practical Considerations

Living Choices participants are responsible for paying for their own room and board in the assisted living facility. Medicaid sets limits on what the assisted living facility may charge for room and board based on the SSI Federal Benefit Rate so that all residents can afford the rate.

Additionally, there are specific medical or health criteria in addition to the standard requirement of nursing home level of care.

Conclusion

Arkansas provides two quality home and community-based waiver programs, ARChoice and Living Choices. Both programs serve seniors who would otherwise qualify for Medicaid if they needed a nursing home level of care but decided to remain in their own homes or community. The Living Choices program is a great option for those who are either currently in a nursing home or know that they would like 24-hours supervision for their medical needs. Living Choices’ more restrictive health criteria limit the participants.

Access all state Medicaid Waiver pages.