Page Reviewed / Updated - Jan. 2017
The Arkansas Independent Choices Waiver follows the Cash and Counseling model. This means that the program grants qualifying state residents a monthly cash allowance to use 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 or in an assisted living residence. Also sometimes called consumer directed or participant directed, the waiver allows those, who are able, to reside outside of a nursing home.
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. The hourly rate that these caregivers are paid is regulated by Medicaid. The average rate for home care in Arkansas is $17 / hr and the Medicaid payment rate would be approximately 50% - 75% of that amount.
The Independent Choices Program is not actually a Medicaid Waiver in its own right, but rather an option on how to receive under other state Waivers such as the ElderChoices Waiver and the Assisted Living Waiver.
To be eligible, one must be at least 18 years old, have a medical need for personal care services, require assistance with their activities of daily living and legally reside in the state of Arkansas. Most importantly, the candidate must be financially eligible for Medicaid in the state of Arkansas.
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. What follows are the requirements relevant to seniors or persons with disabilities in 2017.
Income – Single, divorced, widowed or otherwise unmarried applicants are permitted $2,205 per month in income. Married couples, in which one spouse is seeking assistance can have their incomes considered separately. This permits the non-applicant spouse to have a higher income to prevent them from becoming impoverished. In 2017, they can have up to $3,022.50 per month.
Assets – There are two types of assets, those which Medicaid counts towards the asset limit and those which are not counted. Included in the latter is a home (in which the equity is less than $560,000), a primary vehicle and other personal items. Savings, stocks, bonds, 2nd homes and other property that can be converted to cash are all “countable assets”. Single applicants have a countable asset limit of $2,000. However, married applicants are permitted a much higher asset limit. In 2017, they are allowed to retain between $60,450 and $120,900 and perhaps more.
There are 3 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, 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. Personal emergency response systems may also be covered.
Families should contact the Independence Choices program directly for more information and to apply. However, at the time of writing the Arkansas Independent Choices website was still under construction. Therefore, 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.