Program Description
The Arkansas Independent Choices (IC) program is a member-directed option for seniors and disabled adults that follows the Cash and Counseling model (sometimes referred to as “self-directed,” “consumer-directed,” or “participant-directed”). This means the program grants qualifying state residents a monthly cash allowance to spend on their care. The program allows those who are able to to reside outside of nursing homes.
The program staff also provides counseling should the recipient or their legal representative need further guidance on how to make use of the funds. Typically, program participants elect to spend the funds on their personal care at home.
Family members can be hired and paid to provide personal care services.
An element of the Independent Choices program that makes it particularly attractive to many individuals is that certain relatives 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.
Independent Choices is not a Medicaid program. It is an option on how to receive personal assistance services/attendant care services through two Medicaid programs: Personal Care under the state Medicaid plan and the ARChoices Waiver.
Eligibility Guidelines
General Requirements
To be eligible, one must meet the following requirements:
- Be at least 18 years old
- Have a medical need for personal care services
- Require assistance with his or her activities of daily living
- Legally reside in the state of Arkansas
In addition, the candidate must be financially eligible for a Medicaid program in the state of Arkansas that provides personal care services.
Financial Requirements
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 children, seniors, or young families. For the purposes of this page, the Medicaid programs that are relevant for seniors and persons with disabilities under the Independent Choices Program are the Personal Care Program/state Medicaid and the ARChoices Waiver. The financial requirements for these two programs differ.
Income Limits
Personal Care
In 2024, 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 $943 (100% of the Federal Benefit Rate). For married couples, their income must be no greater than $1,415 a month. Both spouses’ income is considered in the eligibility process, regardless of if one, or both spouses, are applicants.
ARChoices in Homecare Medicaid Waiver
For the ARChoices Medicaid Waiver, a single applicant is permitted up to $2,829 per month in income. For married couples, with both spouses as applicants, the income limit is $5,658 a month. If just one spouse of a married couple is applying for this program, only the income of the applicant spouse is considered — the income of the non-applicant spouse has no impact on his or 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. This is called a monthly maintenance needs allowance. As of 2024, this income allowance could be as much as $3,853.50 a month. If the non-applicant spouse already has monthly income equal to, or above, this figure, a transfer of income is not permitted from the applicant spouse.
Asset Limits
Personal Care
There are two types of assets. Those that Medicaid counts toward the asset limit and those that are not counted. Included in assets that don’t count are one’s home (if a non-applicant spouse does not reside in the home, the applicant’s equity interest must be no more than $713,000), 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. The asset limit remains the same for a married couple regardless of if one or both spouses are applying for benefits. Please note that the assets of a married couple are considered jointly owned.
ARChoices in Homecare Medicaid Waiver
Single applicants have a countable asset limit of $2,000, and married applicants can have assets up to $3,000. Married couples, in which only one spouse is applying for services, are permitted a much higher asset limit. Assets are considered jointly owned for Medicaid eligibility, even if only one spouse is applying for benefits.
The non-applicant spouse can keep 50% of the couple’s assets, up to $154,140 (as of 2024). If the couple’s assets are under $30,828, the non applicant spouse can keep all of the assets, up to this amount. This is called a community spouse resource allowance. Learn more about Medicaid and jointly owned assets here.
Persons who are unsure if they meet the financial criteria or who exceed these criteria may still become eligible by working with a Medicaid Planning professional.
Benefits and Services
There are three categories of personal care related expenses that are paid for by the Independent Choices program.
1) Personal Assistance Services / Respite Personal Assistance Services: Any assistance provided by a person that helps the program participant 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 toward decreasing the program participant’s reliance on other persons. This can include 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 toward 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.
How to Apply / Learn More
Families can contact the Independent Choices program directly at 888-682-0044 for more information and/or to apply. One can also find more information on the Personal Care Program here and a brochure on ARChoices here.
To apply for AR Choices in Homecare, one can call the Choices in Living Resource Center at 1-866-801-3435 or contact their local Department of Human Services (DHS) county office.
Participants of Independent Choices will work with a Financial Management Service vendor. The FMS vendor helps participants manage and understand their budget. Currently, these services are contracted through Palco. Information on working with Palco can be found here. Interested parties who are already eligible for Medicaid can call Palco at 1-866-710-0456 for a program pre-screening.
Those persons who are not yet on Medicaid must first apply for Medicaid. Information about the application process can be found here. Again, it is recommended that persons who are unsure if they are eligible consult with a Medicaid planner before application.
