016.20.07 Ark. Code R. 004
The following programs are available for facility and non-facility care for individuals with long-term medical needs. These programs have common income and resource requirements.
Income Limit
The income limit for all of the following programs is three times the current SSI Standard Payment Amount (SPA) for an individual. The income limit for 2007 is $1,869. The income limit increases at the first of each calendar year. Only the income of the applicant is counted toward this limit. In some categories, if there is a non-institutionalized spouse, the spouse may be eligible to keep all or a portion of the institutionalized individual's income.
Resource Limit
The resource limit for the covered individual is $2,000. In some programs, if the covered individual has a spouse, the spouse may be eligible to keep all or a portion of the total spousal resources. See Resource Rule.*
Nursing Facilities
Institutions that provide medically necessary care 24 hours per day for residents who require skilled nursing care, rehabilitation services or health-related care and services above the level of room and board and not primarily for the care and treatment of mental diseases. Recipients receive the full range of Medicaid benefits. Medicaid also pays all or a portion of monthly facility vendor payment depending on the monthly income to be considered.
Individuals in Nursing Facilities with income over the current limit may become eligible for Medicaid by establishing an Income Trust. The DHS caseworkers have information about Income Trusts.
Non-institutionalized spouses of Nursing Facility recipients are eligible for the division of spousal resources and income.
In addition to being income and resource eligible, the Nursing Facility resident must be aged, blind or disabled and require medical care of a certain level, determined by the Office of Long Term Care.
Assisted Living Facilities Level II
Facilities that provide assistance with activities of daily living to individuals in a residential setting. Living units and common space are provided to address all activities of daily living on a 24-hour basis. Individuals in Level II Assisted Living Facilities are eligible for the full range of Medicaid benefits. Room and board cost are not included in the waiver coverage.
Individuals with income over the current limit may become Medicaid eligible by establishing an Income Trust. Non-institutionalized spouses of Assisted Living Facility recipients are eligible for the division of spousal income and resources.
Assisted Living Facilities Medicaid requires an Intermediate Level of Care as determined by the Office of Long Term Care. Individuals requiring Skilled Care are not eligible for this program.
ElderChoices (Alternative Community Services Program for the Aged)
Home-based care for individuals aged 65 and over. ElderChoices provides homemaker services, chore services, home delivered meals, Personal Emergency Response System, Adult
Day Health Care, Adult Foster Care, Respite Care, Adult Day Care and Adult Companion
Services. ElderChoices provides the full range of Medicaid benefits.
Applicants with spouses living in the community are eligible for the division of spousal resources, but not for spousal income as the recipient does not contribute income to his or her care.
Individuals eligible for ElderChoices require an Intermediate Level of Care as determined by the Office of Long Term Care. Individuals requiring Skilled Care are not eligible.
Alternatives for Adults with Physical Disabilities (AAPD)
Home and community based care for physically disabled individuals aged 21 to 64 as an alternative to institutionalization. AAPD provides Attendant Care and Environmental Accessibility Adaptation Services and the full range of Medicaid benefits.
Individuals eligible for AAPD require an Intermediate Level of Care as determined by the Office of Long Term Care. Individuals requiring Skilled Care are not eligible.
PACE - (Program of All-Inclusive Care for the Elderly)
A comprehensive health and social services program that provides and coordinates primary, preventive, acute and long term care services for individuals 55 years of age or older who need nursing facility care. Services are provided in PACE Centers, in the home and in inpatient facilities. Individuals eligible for PACE must live in an area served by a PACE program and be able to live in a community setting without jeopardizing their health or safety.
PACE applicants with income over the income limit may become eligible for Medicaid by establishing an Income Trust. DHS caseworkers have additional information regarding Income Trusts. PACE participants with spouses living in the community are eligible for the division of spousal income and resources.
Individuals eligible for PACE require a nursing home Level of Care as determined by the Office of Long Term Care. The PACE program is expected to begin soon and will be available to individuals in the Jonesboro area.
DDS Waiver
Home and community based care for individuals with developmental disabilities who would otherwise require an ICF/MR Level of Care in an institution. DDS Waiver provides the full range of Medicaid benefits as well as other specialized services. Contact DDS at 501-682-8662 for information about this program.
016.20.07 Ark. Code R. 004