Program Description
AR Choices in Homecare provides a variety of services to assist Arkansas residents in living independently, in their own home or the home of a relative. This program not only assists in meeting their needs, but also helps to reduce premature nursing home placements. Services/benefits available include home modifications (for example, installation of ramps for wheelchair access or the addition of grab bars), adult day care, respite care, and assistance with Activities of Daily Living (ADLs)/Instrumental Activities of Daily Living (IADLs) (bathing, putting on/taking off clothes, meal preparation, light housecleaning, etc.).
Attendant care services may be self-directed. This means an AR Choices in Homecare program participant may hire, train, manage, and even fire the caregiver of their choosing. This is done through the related Independent Choices Program. Friends and family members, with the exception of spouses and legal guardians, can be hired to provide care.
AR Choices in Homecare, also simply referred to as AR Choices, is a Medicaid Waiver program for frail elders and physically disabled adults. Implemented in January of 2016, this waiver merged two former waivers: Elder Choices (EC) and Alternatives for Adults with Physical Disabilities (AAPD). AR Choices is operated by the Arkansas Department of Human Services’ Division of Aging, Adult, and Behavioral Health Services (DAAABHS) and the Division of Provider Services and Quality Assurance (DPSQA).
Eligibility Guidelines
General Requirements
To be eligible for AR Choices, an applicant must be a resident of Arkansas who is physically disabled between the ages of 21 and 64, or is 65 years of age or older. In addition, functional requirements must be met. All applicants must require a nursing home level of care and require a minimum of one of the services offered through AR Choices.
Financial Requirements
Income Limits
Financially, as of 2024, a single applicant must not have income greater than $2,829 / month. This figure is equivalent to 300% of the SSI Federal Benefit Rate (FBR). For a couple, when both spouses are applying, each spouse is limited to $2,829 / month, for a total of $5,658.
However, when only one spouse is applying, the non-applicant spouse may be entitled to a portion of their applicant spouse’s 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
Countable assets, which are assets that are easily converted to cash, such as bank accounts, mutual funds, and stocks, are limited to $2,000 for an individual and $3,000 for couples with both spouses applying.
However, several assets are considered non-countable (exempt), such as one’s primary home, given the applicant’s equity interest does not exceed $713,000 (in 2024) and the applicant resides in it. If a non-applicant resides in the home, it is exempt regardless of applicant circumstances. Additional exemptions include household goods, burial trusts, and personal items, such as one’s wedding ring.
In addition, in 2024, the non-applicant spouse can keep 50% of the couple’s assets, up to $154,140. If the couple’s assets are under $30,828, the non applicant spouse can keep all of the assets, up to this amount. Learn more about Medicaid and jointly owned assets here.
Over the Financial Limits?
For those who do not meet the financial requirements, there are ways to effectively lower one’s income and assets in order to meet program eligibility. For instance, Miller Trusts are an effective way to lower one’s income. Additional assets can be “spent down” on exempt (non-countable) assets, such as purchasing an Irrevocable Funeral Trust and modifying one’s home to be wheelchair accessible. If one is over the income and / or asset limit(s), it is highly recommended the counsel of a professional Medicaid planner be sought.
Please note: It is crucial that one does not give away assets or sell them cheaply in order to meet Medicaid’s asset limit. This is because Medicaid has a look-back period (60 months in Arkansas) in which all past asset transfers within the defined period are reviewed. If one has gifted assets or sold them under fair market value, he or she will be ineligible for Medicaid for a determined period of time.
Benefits and Services
Via AR Choices Medicaid waiver, the following services may be available:
- Home modifications
- In-home and out-of-home respite care
- Adult day care / adult day health
- Personal emergency response systems (PERS)
- Meal delivery
- Attendant care – Assistance with ADLs and IADLs
Please note that Adult Family Home (Adult Foster Care) is no longer an available benefit via AR Choices in Homecare. It was eliminated in January of 2019.
How to Apply / Learn More
For additional information on AR Choices in Homecare, or to apply, 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.
An AR Choices program brochure can be downloaded here, and additional information can be found on the DHS website.