How to Apply for Arkansas Medicaid for Dementia Care: Step-by-Step Process

Applying for Medicaid in Arkansas to cover dementia care isn't a single form — it's a coordinated process involving two separate applications, a clinical assessment, and potentially setting up a legal trust structure. Most families don't realize they're submitting to multiple agencies simultaneously until they're already deep in the process.

Here's the complete sequence, in the order it should happen.

Step 1: Secure Legal Authority First

Before you can sign applications, contracts, or trust documents on your parent's behalf, you need legal authority. If your parent still has cognitive capacity, get a Durable Financial Power of Attorney and a Healthcare Power of Attorney signed and notarized. If capacity is already lost, you'll need a court-appointed guardianship (a separate, longer process).

Do not skip this step. DHS will not process an application signed by a family member who lacks legal authority to act for the applicant.

Step 2: Schedule the ARIA Assessment

Contact the Choices in Living Resource Center at 1-866-801-3435 or your regional Area Agency on Aging. Submit a Personal Care Referral Form to initiate the Arkansas Independent Assessment (ARIA).

An independent registered nurse will conduct the ARIA in your parent's home, using a standardized evaluation with over 300 questions covering physical limitations, daily living ability, and cognitive impairment. The assessment determines whether your parent meets the nursing-facility level of care required for waiver programs.

Your parent needs to score Tier 2 or above to qualify for the ARChoices in Homecare waiver or the Living Choices Assisted Living Waiver. For dementia, this means documented diagnosis plus behaviors requiring constant supervision (wandering, medication mismanagement, safety hazards).

The assessment is typically scheduled within 14 to 30 days of the referral. It's free.

Preparation tip: Don't coach your parent to perform better than their actual daily functioning. The ARIA needs to capture their worst realistic day, not their best one. If they wander at night, can't manage medications, or need hands-on help with bathing and dressing, make sure those details are clearly communicated to the evaluator.

Step 3: Handle the Income and Asset Problem

Before submitting the financial application, you need to know whether your parent's numbers work.

Income check: If gross monthly income exceeds $2,982, your parent needs a Miller Trust (Qualified Income Trust). This is an irrevocable trust with a dedicated checking account at an Arkansas bank. All income (or the excess above the cap) flows through this account monthly and is disbursed in a strict order: $40 personal needs allowance, spousal maintenance (if applicable), insurance premiums, then facility payment.

The Miller Trust must be executed, the bank account opened, and income deposited in the same month as the Medicaid application. Retroactive coverage isn't available before the trust's operational date.

Asset check: Countable assets must be at or below $2,000 for a single applicant. Arkansas counts IRAs, 401(k)s, checking/savings accounts, CDs, stocks, bonds, and real estate beyond the primary home. Exempt assets include the home (up to $752,000 equity), one vehicle, personal belongings, and prepaid irrevocable burial contracts.

If assets exceed $2,000, convert countable assets to exempt ones: pay off the mortgage, purchase an irrevocable burial contract, pay down debts, or make necessary home modifications. Do not give assets away — transfers within 60 months trigger look-back penalties.

Step 4: Submit the Dual Application

Two separate submissions happen in parallel:

Financial application: Submit Form DCO-0004 (Application for Healthcare) to the county DHS Division of County Operations office. This form establishes financial eligibility. Bring:

• Completed application form
• 60 months of bank statements for every account
• Social Security award letters and pension statements (proof of all gross income)
• Medicare card copies
• Health insurance premium statements
• Signed Miller Trust agreement (if applicable)
• Proof of all asset transfers in the past 60 months

Medical determination: Your parent's primary physician must submit Form DMS-703 (Medical Need Determination) directly to the Office of Long Term Care. This certifies clinical necessity. If your parent is entering a facility, the facility completes Form DMS-787 (PASRR screening) as well.

Step 5: Wait (and Plan)

DHS has up to 45 days to issue a determination. During this period:

• If your parent needs immediate placement, you'll be paying private rates until Medicaid kicks in
• If waiver slots are full (the Living Choices Waiver is capped at 1,725 statewide), your parent goes on a centralized waitlist with priority based on clinical criteria, not chronological order
• Nursing facility Medicaid is an entitlement — no waitlist for financially and medically eligible applicants

Use the waiting period to tour facilities, verify licensing (use the OLTC Facility Search tool), and prepare for the admission process.

Step 6: Verify and Sign

Once approved, DHS issues an eligibility determination. If your parent is entering a memory care facility under the Living Choices Waiver, remember that the waiver covers services only — room and board is private pay ($2,500 to $5,000+/month). Sign the admission agreement and verify the facility's ASCU certification and compliance history.

Common Application Mistakes

• Applying before the Miller Trust is active — the trust must be funded in the same month as the application
• Missing the 60-month documentation — DHS will request full bank statements; gaps or missing accounts delay the determination
• Not listing all income sources — VA benefits, retirement distributions, and investment income all count
• Assuming the online Access Arkansas portal is the full application — it's a submission interface, not a guided process. You still need all supporting documentation

The Arkansas Dementia & Memory Care Guide includes a complete application packet checklist, ARIA preparation worksheet, and Miller Trust setup instructions — everything organized in the order you need it, with the specific Arkansas forms and contacts for each step.

See more Arkansas guides →