Personal Care is one of several services offered to residents of Arkansas who are in need of long-term services and supports (LTSS) through the Arkansas state Medicaid program. Personal Care is administered by trained providers, and includes hands-on assistance with activities of daily living, such as basic hygiene, bathing, getting dressed, and going to the bathroom. This allows a beneficiary to continue to live in his/her own home. Persons who reside in assisted living (residential care facilities (RCFs), but not nursing homes) can receive personal care paid for by Medicaid if the RCF is enrolled as a personal care provider with the state Medicaid program.
Eligible applicants’ for the Personal Care Program are able to self-direct their own care via the consumer-directed personal care state plan option called the Independent Choices program. Often called consumer direction, eligible applicants are able to hire, train, manage, and even fire, the personal caregiver of their choosing. Friends and family members can be hired, except for spouses and legal guardians.
In addition to, or as a possible alternative to the Personal Care program, several other Medicaid programs are available in Arkansas, which provide additional service options. Programs such as ARChoices and the Program of All Inclusive Care for the Elderly (a joint Medicaid & Medicare program) are also designed to facilitate consumer-directed care at home, such as hiring a family member or a friend to provide care.
The Division of Medical Services (DMS) administers the Personal Care program, together with the rest of the state’s Medicaid network.
Functional and Residence Requirements
Medicaid will cover Personal Care in Arkansas for all state residents, regardless of age, if a doctor deems it necessary to deliver care to a recipient in the home or primary residence. However, one’s residence cannot be a nursing home or intermediate care facility.
Income and Assets Requirements
Income and asset requirements for Medicaid are age dependent. Single residents, aged 65 and older, must not have a monthly income that exceeds 100% of the SSI Federal Benefit Rate. In 2021, this means that an individual cannot receive more than $794 a month in income. A married couple (regardless of if one or both spouses are applicants) cannot have income in excess of $1,191 / month. The income limits are revised annually as the Federal Benefit Rate is revised. Note that there are other previously mentioned AR Medicaid programs that provide personal care to persons with higher income levels.
There is also a countable asset limit, which is set at $2,000 in 2021 for a single applicant, and $3,000 for married applicants. However, one’s home may be exempt (not counted towards the limit), given that the applicant’s equity interest is not over $603,000 and he/she lives in the home. The home is also exempt, regardless of other circumstances, if a non-applicant spouse lives in it. A vehicle, life insurance policies that don’t have cash surrender value, household items, and burial trusts may also be exempt.
Persons who qualify for Medicaid by way of the Medically Needy Spend Down pathway are not eligible for personal care under this option. The Medically Needy pathway is a path of eligibility for individuals with high medical bills. Basically, one “spends down” their excess income on medical bills in order to reach Medicaid’s income limit, and hence, qualify for Medicaid.
Being over the income and/or asset limit(s) is not automatic cause for disqualification from Arkansas Medicaid. If one is over the limit(s), it is highly recommended that he/she seek the counsel of a Medicaid planner. These professionals are knowledgeable in restructuring finances to meet Medicaid’s requirements without jeopardizing one’s eligibility. Please note that there is a 60-month look back from the date of one’s Medicaid application to ensure assets were not gifted or sold for less than they are worth. If one is found to have violated the look back period, one may be penalized with a period of Medicaid ineligibility.
Personal Care encompasses many categories of hands-on services that are provided in a person’s own home by a licensed caregiver. This includes assistance with bathing, eating and preparing food, exercise and mobility, medications, basic hygiene, laundry, shopping for essentials, and more. The categories of service a client may receive are based on his/her needs as determined by a physician. This program has zero co-pays for beneficiaries.
To apply for Medicaid in Arkansas, contact the nearest county office of the Department of Human Services (DHS). A full list of local offices can be found here.
To contact the state office, call (501) 682-8233, or toll-free, 800-482-8988.