ARChoices in Homecare Waiver Explained

The ARChoices in Homecare Waiver is a Medicaid program designed to provide individuals in Arkansas with long-term care services and support in their homes or communities. In this blog post, we will explore the details of the ARChoices in Homecare Waiver, including its purpose, eligibility criteria, services offered, and application process. 

By understanding this waiver program comprehensively, individuals and families can make informed decisions about long-term care options and access the necessary support to age or recover in the comfort and familiarity of their own homes.

Overview of ARChoices in Homecare Waiver

The program offers various services to assist participants in their daily living activities. These services may include personal care, skilled nursing care, homemaker services, respite care, and adult day care. The services provided are based on the individual's assessed needs and preferences.

ARChoices provides a consumer-directed option, allowing participants or their designated representatives more control over their care. This option allows individuals to hire and manage their caregivers, including family members or friends, within specific guidelines and regulations.

The ARChoices program strives to enhance participants' independence and quality of life. By providing a range of in-home care services, such as personal care and skilled nursing care, the program supports individuals in maintaining their daily living activities and accessing the necessary support to meet their health and personal needs.

Eligibility requirements

Here are the general eligibility requirements for the ARChoices in Homecare Waiver:

1. Age: The program is available to individuals aged 21 and older with a disability that meets the criteria for a certain level of care.
2. Financial Eligibility: Applicants must meet the financial requirements for Medicaid in Arkansas, which include income and resource limitations. As of 2023, single applicants cannot have income greater than $2,742 per month, which is 300% of the SSI Federal Benefit Rate (FBR). Couples applying are limited to $5,484 per month, with each spouse limited to $2,742. If only one spouse applies, the non-applicant spouse may be entitled to a portion of the applicant's income, called a monthly maintenance needs allowance, which as of 2023 could be as much as $3,715.50 per month. For more information, visit the program's webpage.
3. Functional Eligibility: Applicants must require a level of care typically provided in a nursing or intermediate care facility for people with intellectual disabilities (ICF/IID). A comprehensive assessment is conducted to determine functional eligibility.
4. Choice of Community-Based Services: Individuals must choose to receive home and community-based services instead of institutional care, meaning they prefer to receive care and support in their homes or community settings.
5. Residence: Applicants must be residents of Arkansas and meet the residency requirements established by the Arkansas Department of Human Services.

Meeting these eligibility requirements does not guarantee enrollment in the program, as there may be a waiting list due to the availability of program slots. 

Application Process and Determining Eligibility

The application process for the ARChoices in Homecare Waiver program in Arkansas typically involves several steps, including the following: 

1. Contacting the Arkansas Department of Human Services (DHS): Contact the DHS to express your interest in applying for the ARChoices in Homecare Waiver program. You can contact your local DHS office or the central DHS helpline to inquire about the application process and request an application packet.
2. Completing the Application: After receiving the packet, carefully fill it out, providing accurate and detailed information about the individual seeking services. The application will include personal and financial information and details about the individual's disability and need for home and community-based services.
3. Gathering Supporting Documentation: Along with the completed application, you may be required to submit additional documents to support the application. This may include proof of identity, income verification, medical records, and any other relevant documentation requested by the DHS.
4. Submitting the Application: After completing the application and gathering all the necessary supporting documents, submit the application packet to the DHS. Review the instructions to determine the appropriate submission method, such as mailing it to a specific address or delivering it in person.
5. Assessment and Determination: Once the DHS receives your application, they will review it and may schedule an assessment to evaluate the individual's functional eligibility. A comprehensive evaluation is conducted to determine if the individual meets the level of care required for the ARChoices in Homecare Waiver program.
6. Notification of Eligibility: After the assessment and review process, you will receive a statement from the DHS regarding the individual's eligibility status for the program. If approved, the notification will outline the following steps, including any required agreements or documents to be signed.
7. Enrollment and Service Planning: The next step involves enrollment if the individual is deemed eligible. This typically includes developing a care plan, selecting a provider agency, and coordinating the delivery of home and community-based services.

Note that there may be a waiting list for enrollment due to the availability of program slots. 

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Services and supports

The ARChoices in Homecare Waiver provides services and support to eligible individuals to help them receive care and support in their homes or community settings instead of institutional care. While the specific services may vary based on individual needs and preferences, here are some examples of services and supports typically provided under the ARChoices in Homecare Waiver program:

1. Personal Care Services: Assistance with activities of daily living (ADLs) such as bathing, dressing, grooming, toileting, and mobility.
2. Homemaker Services: Help with light housekeeping, meal preparation, and household chores.
3. Respite Care: Temporary relief for primary caregivers by providing short-term care for individuals, allowing caregivers to take a break or tend to other responsibilities.
4. Home Health Services: Skilled nursing care, wound care, medication management, and other medical services provided in the individual's home.
5. In-home Therapy Services: Physical therapy, occupational therapy, or speech therapy is provided at home to improve mobility, functionality, and communication skills.
6. Assistive Technology: Equipment, devices, or technology solutions that enhance independence and support individuals with disabilities in their daily activities.
7. Adult Day Services: Structured programs and activities provided in a community-based setting during the day, offering socialization, supervision, and assistance with personal care needs.
8. Case Management: Assistance with care coordination, service planning, and accessing necessary resources and support.
9. Environmental Modifications: Adaptations and modifications to the home environment to enhance accessibility and safety, such as installing ramps, grab bars, or widening doorways.
10. Transition Assistance: Support services to help individuals transition from institutional care to their homes or community settings.

The availability of services may be subject to certain limitations, and the specific services provided may vary based on the individual's assessed needs, preferences, and available resources within the program.

Compensation for caregivers 

ARChoices does not directly compensate unpaid family caregivers for their services. 

Still, in some cases, family caregivers may be eligible for reimbursement through a self-directed option within the program. This option allows qualified individuals to hire and manage their caregivers, including family members, and allocate a portion of the waiver funds to compensate them.

This reimbursement process typically involves specific requirements, documentation, and reporting procedures that must be followed to ensure compliance with program guidelines.

To explore the possibility of reimbursement as a family caregiver, we recommend contacting the Arkansas DHS.

Limitations and challenges 

Like many other programs, Arkansas's ARChoices in Homecare Waiver program faces certain limitations and challenges. These can include funding constraints and limited program slots or service availability. Additionally, there may be waiting lists for enrollment due to high demand. Gaps in coverage may also arise, where certain services or supports may not be fully covered or available under the program. It's important for individuals and caregivers to stay informed about these potential limitations and challenges and explore alternative options or resources when necessary.

A note from Givers

Caregivers often face significant stress and burnout due to the constant demands of caregiving. When caregivers receive recognition and support, they can provide better care to the individuals they support. We invite you to complete this form to determine if you may be eligible for caregiver compensation.