The Living Choices Assisted Living waiver program enables individuals to live in apartment-style units in licensed Level II assisted living facilities and receive individualized personal, health, and social services that maintain their individuality, privacy, dignity, and independence. The assisted living environment supports these values through effective service delivery and facility operations. The environment promotes participants' personal decision-making while protecting their health and safety. The primary goal is to delay or prevent institutionalization. However, assisted living services are not a substitute for nursing facility or hospital care for individuals needing skilled care. Room and board services are not covered per federal law.
Living Choices provides 24-hour on-site response staff to assist with participants' physical dependency needs and manage emergencies. Staff conduct themselves in ways that foster participants' dignity and independence. The program emphasizes supervision, safety, and security. It includes therapeutic, social, and recreational activities tailored to participants' abilities and interests. Living units are separate and distinct from others. Laundry, meal preparation, and dining services are available in communal settings for participants who choose not to perform these activities. The program follows principles of negotiated service plans and managed risk.
Extended Prescription Drug Coverage is available for participants eligible for regular Medicaid drug benefits, plus three additional prescriptions. Participants with dual Medicare and Medicaid eligibility must obtain medications through the Medicare Part D Prescription Drug Plan, or through the Arkansas Medicaid State Plan Pharmacy Program for certain excluded medications.
The Division of County Operations (DCO) Long-Term Services and Supports (LTSS) unit processes initial applications to determine financial and functional eligibility. LTSS eligibility workers assess financial eligibility and refer applicants to an independent assessment contractor for functional eligibility evaluation.
The Independent Assessment Contractor uses the Arkansas Independent Assessment (ARIA) instrument to evaluate functional needs. This assessment helps determine medical and financial eligibility and informs the participant's Person-Centered Service Plan (PCSP). Every 12 months, a DHS PCSP/CC Nurse evaluates the participant using DHS Form 703 to verify continued medical and functional need. Changes in condition may trigger reassessment. DMS and DAABHS jointly oversee the Independent Assessment Contractor and ARIA system.
The Division of Aging, Adult, and Behavioral Health Services (DAABHS) operates the Living Choices Assisted Living Waiver under the Division of Medical Services (DMS), the State Medicaid agency. Both operate within the Arkansas Department of Human Services (DHS). DMS monitors operations, establishes provider regulations, handles reimbursements, and oversees delegated functions. DAABHS develops administrative policies, manages service plans, and provides care coordination.
The person-centered service plan reflects the participant's assigned tier level, determined by the ARIA assessment or the annual evaluation completed by the PCSP/CC nurse using DHS Form 703.