Page Reviewed / Updated - Jan. 2019
The Arkansas Independent Choices program is a member-directed option for seniors and disabled individuals that follows the Cash and Counseling model. This means that the program grants qualifying state residents a monthly cash allowance to spend on their care. The program staff also provides counseling should the recipient or their legal representative require further guidance on how to make use of the funds. Typically, program participants elect to spend the funds on their personal care at home. Also sometimes called self-directed, consumer directed, or participant directed, the program allows those, who are able, to reside outside of a nursing homes.
An element of the Independent Choices program that makes it particularly attractive to many individuals is that certain family members can be hired and paid to provide personal care services. While one’s spouse and legal guardian cannot be hired, other family members including the adult children of aging parents can be paid for providing care. Medicaid regulates the hourly rate in which these caregivers are paid. That being said, the average rate for home care in Arkansas (as of 2019) is $18.00 / hr., and the Medicaid payment rate would be approximately 50% - 75% of that amount.
The Independent Choices Program is not a Medicaid Waiver, but rather an option on how to receive personal assistance services under the Arkansas’ State Medicaid Personal Care Program and the ARChoices Medicaid Waiver. This program is managed by the Arkansas Department of Human Services’ (DHS) Division of Aging and Adult Services (DAAS).
To be eligible, one must be at least 18 years old, have a medical need for personal care services, require assistance with his/her activities of daily living and legally reside in the state of Arkansas. Most importantly, the candidate must be financially eligible for a Medicaid program in the state of Arkansas that provides personal care services.
Financial eligibility for Medicaid is a complex subject and the details depend on the personal situation of the applicant. For example, pregnant women have different requirements than do children, seniors, or young families. For the purposes of this page, two such programs are relevant for seniors and persons with disabilities: Personal Care Program via the Arkansas state Medicaid plan and the ARChoices Medicaid Waiver. As mentioned previously, financial eligibility is complicated, and the financial requirements for the Personal Care Program and ARChoices Waiver differ.
Income – As of early 2019, in order for a single, divorced, widowed, or otherwise unmarried applicant to be financially eligible for the Personal Care Program, one must have monthly income less than $771 (73% of the Federal Poverty Level). For the ARChoices Medicaid Waiver, a single applicant is permitted up to $2,313 per month in income. For married applicants, the couple’s income limit is $1,157 / month for the Personal Care Program, and for the ARChoices Medicaid Waiver, the income limit remains the same as for single applicants; $2,313 / month per applicant. If only one spouse of a married couple is applying for Medicaid, only the income of the applicant spouse is considered. Stated differently, the income of the non-applicant spouse has no impact on his/her spouse’s eligibility when it comes to the income limit. However, non-applicant spouses may be entitled to a portion of their applicant spouses’ income. As of 2019, this could be as much as $3,160.50 / month.
Assets – There are two types of assets, those that Medicaid counts towards the asset limit and those that are not counted. Included in the latter are one’s home (in which the equity is less than $585,000), household furnishings, a primary vehicle, and other personal items. Savings, stocks, bonds, second homes, and other property that can be converted to cash are all “countable assets”. Single applicants have a countable asset limit of $2,000, and married applicants can have assets up to $3,000. However, married couples, in which only one spouse is applying for services, are permitted a much higher asset limit. Different from the income rules stated above, assets are considered jointly owned for Medicaid eligibility, even if only one spouse is applying for benefits. In 2019, non-applicant spouses are allowed to retain up to $126,420 of the couples assets. Learn more about Medicaid and jointly owned assets here.
There are three categories of personal care related expenses that are paid for by the Independent Choices program.
1) Personal Assistance Services – any assistance provided by a person that helps the program participant to accomplish their activities of daily living such as bathing, dressing, toiletry, mobility, eating, and personal hygiene.
2) Products and Services that Increase Independence – these are goods and services that contribute towards decreasing the program participant’s reliance on other persons, such as remote controls for operating lighting or household appliances, as well as technology-enabled services, such as personal emergency response and remote monitoring. Items to improve the health of the eligible individual, such as nutritional supplements and medications not covered by Medicaid may also be purchased via the monthly allowance allotted by this program.
3) Home Modifications and Assistive Technologies – participants can save their monthly compensation to put towards the purchase of higher cost items or services, such as wheelchair ramps, stair-glides, walk-in tubs, and other modifications that increase their ability to live independently. As mentioned previously, personal emergency response systems may also be covered.
Families should contact the Independent Choices program directly for more information and to apply. One can also download an Independent Choices manual here for additional information. Interested parties who are already eligible for Medicaid, should call 1-866-710-0456 for a program pre-screening.
Those persons who are not yet on Medicaid, must first apply for the program. They can learn more about the process here. Again, it is emphasized that if one is not sure if they will be eligible, that they consult with a Medicaid planner prior to application.