The ARChoices in Homecare (ARChoices) waiver provides cost-effective, person-centered home and community-based services as an alternative to nursing home placement. This program serves people aged 21 to 64 with physical disabilities and those 65 and older who require an intermediate level of care in a nursing facility but do not need skilled care.
Services are delivered through individualized person-centered service plans (PCSPs). ARChoices offers Attendant Care, Adult Day Services, Adult Day Health Services, Home-Delivered Meals, Personal Emergency Response System (PERS), Environmental Accessibility Adaptations/Adaptive Equipment, Prevocational Services, and Respite Care (in-home and facility-based). Each PCSP is developed collaboratively with the participant, incorporating findings from the Arkansas Independent Assessment (ARIA) and discussions about their preferences, goals, desired outcomes, and risk factors.
The Independent Assessment Contractor conducts functional needs assessments using the ARIA instrument. This assessment helps determine medical and financial eligibility and guides PCSP development. Participants undergo evaluations every 12 months to verify continued medical and functional need or identify changes affecting eligibility. If evidence shows significant changes in functional or medical needs, a reassessment may be requested. DMS and DAABHS jointly oversee the Independent Assessment Contractor and ARIA system.
The Division of Aging, Adult, and Behavioral Health Services (DAABHS) operates ARChoices under the Division of Medical Services (DMS), the State Medicaid agency. Both divisions operate within the Arkansas Department of Human Services (DHS). DMS oversees ARChoices operations, establishes provider manuals and regulations, manages provider reimbursement, and supervises delegated functions. DAABHS implements operational policies, oversees PCSP development and management, and provides care coordination.
The ARIA instrument assigns participants to tier levels based on their functional needs assessment. These tiers inform both the person-centered service plan and the ISB.
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ARChoices eligibility requires a determination of categorical eligibility, a determination of level of care, the development of a plan of care and a cost comparison to determine the cost-effectiveness of the plan of care.
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