ARChoices in Homecare Waiver: Eligibility, Services, and How to Apply

Your parent needs daily help with bathing, dressing, and getting around the house — but nursing home care isn't the right fit and private-pay home care at $26 per hour is burning through their savings. The ARChoices in Homecare waiver is Arkansas's primary Medicaid program for keeping people safely at home instead of in a nursing facility.

Here's what it covers, who qualifies, and how to navigate the application process.

What the ARChoices Waiver Covers

ARChoices consolidated Arkansas's older "ElderChoices" and "Alternatives for Adults with Physical Disabilities" waivers into a single program in 2016. It's managed by the Division of Provider Services and Quality Assurance (DPSQA) and local DHS county offices.

The waiver covers a broad set of home and community-based services:

• Attendant care — help with bathing, dressing, toileting, transferring, meal preparation, light housekeeping
• Adult day services and adult day health care — supervised daytime programs (the state median runs about $80 per day)
• Respite care — both in-home and facility-based temporary relief for family caregivers
• Home-delivered meals — daily hot meals plus shelf-stable meals for weekends
• Personal Emergency Response Systems (PERS) — emergency call buttons and fall detection
• Environmental modifications — grab bars, wheelchair ramps, bathroom modifications
• Non-medical transportation — rides to appointments, pharmacies, and essential errands

The specific services and hours you receive are determined by a Person-Centered Service Plan (PCSP), which is built around your parent's assessed functional needs.

Who Qualifies for ARChoices

Eligibility has three gates — all three must be met:

Age or disability requirement. The applicant must be 65 or older, or an adult aged 21-64 with a physical disability.

Functional requirement. The applicant must need an intermediate Nursing Facility Level of Care. This means they need extensive assistance (weight-bearing support) with at least one critical activity of daily living — transferring, eating, or toileting — or limited assistance at least three times per week with at least two of those three. Alternatively, they qualify if they have a documented dementia diagnosis requiring substantial supervision due to safety-threatening behaviors, or an unstable medical condition requiring daily professional monitoring.

Financial requirement. Gross monthly income cannot exceed $2,982 (2026 limit). Countable assets must be below $2,000 for a single applicant. If income exceeds the limit, a Miller Trust resolves this. The family home is exempt up to $752,000 in equity.

ARChoices is not an entitlement — it has enrollment caps. When capacity is full, applicants go on a waitlist prioritized by application date or crisis criteria (90-day nursing home stay, active adult protective services case).

The ARIA Assessment: What to Expect

The functional evaluation is conducted by Optum State Government Solutions using the Arkansas Independent Assessment (ARIA) tool — a computerized system based on Minnesota's MnCHOICES framework. It's more than 300 questions administered during an in-person interview at the applicant's home.

The assessment generates a tier score that determines how many care hours are authorized. Tier 0 or Tier 1 results in denial — the applicant's needs don't meet the nursing-facility threshold. Higher tiers authorize progressively more attendant care hours.

To prepare, gather complete medical records, physician diagnostic letters (especially confirming dementia diagnoses), and a full medication list. Document your parent's worst days, not their best — the assessment needs to capture their actual level of dependency.

How to Apply: Step by Step

1. Contact the Choices in Living Resource Center at 1-866-801-3435 or reach out to your regional Area Agency on Aging. They'll initiate the clinical screening referral.

2. DHS transmits the referral to Optum, which contacts the family to schedule the in-person ARIA assessment.

3. While waiting for the assessment, structure the finances. If income exceeds $2,982, draft a Miller Trust and open a dedicated bank account. If countable assets exceed $2,000, execute a documented spend-down (prepay funeral expenses, pay off the mortgage, fund home modifications).

4. Submit Form DCO-0004 (Application for Healthcare/Long Term Care Assistance) to the local DHS Division of County Operations. On Page 1, check the box marked "ARChoices in Homecare" — this is critical. Missing this checkbox routes the application to standard health insurance queues instead of the long-term care unit.

5. Include supporting documents: photo IDs, Social Security cards, the home deed, three months of bank statements for all accounts, and Miller Trust documents if applicable.

The Independent Choices Alternative

If your parent wants more control over their care, the Independent Choices program (a 1915(j) state plan option) allows them to serve as the employer of record and hire their own caregivers — including family members. However, under Arkansas regulation 016.25.22, spouses and court-appointed legal guardians cannot be hired as paid caregivers under this program.

The Arkansas Home Care Navigation Guide covers the full ARChoices application process, ARIA assessment preparation, Miller Trust setup, and Independent Choices enrollment — with checklists and templates for every step.

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