Arkansas Administrative Code › Agency 016 - DEPARTMENT OF HUMAN SERVICES › Division 20 - Division of County Operations › Rule 016.20.07-003 - Changes to the Alternatives for Adult with Physical Disabilities Waiver (AAPD)

Current through Register Vol. 49, No. 6, June, 2024
26100
Aging and Adult Services Waivers
The Division of Aging and Adult Services (DAAS) sponsors home
				and community based Waiver programs providing non-institutional long term care
				services to individuals as an alternative to institutionalization in a long
				term care facility. Individuals eligible for DAAS Waiver services must be
				potentially eligible for admission to a long term care facility and must
				require an Intermediate Level of Care. The ElderChoices program provides
				services for individuals aged 65 and over. The Alternatives for Adults with
				Physical Disabilities Home and Community-Based Waiver Program (AAPD) provides
				services for individuals aged 21 through 64.
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History of
			 ElderChoices and AAPD Waiver
ElderChoices
: Arkansas implemented
				the Alternative Community Services (ACS) Program for the Aged (ElderChoices)
				effective August 1, 1991. Authorization for the ElderChoices program was
				established by Section 2176 of the Omnibus Budget Reconciliation Act of 1981,
				Public Law 97-35.
Alternatives for Adults with Physical Disabilities
				Waiver
: Federal Regulations at
				42 CFR
				435.217 allows states to provide home and
				community based waiver services to physically disabled individuals under age 65
				as an alternative to institutionalization.
On July 1, 1997, Arkansas implemented the statewide
				Alternatives for Adults with Physical Disabilities Home and Community Based
				Waiver Program (AAPD) for individuals aged 21 through 64.
Effective July 1, 2007, AAPD recipients turning age 65 will
				have a choice of remaining in the AAPD waiver or transitioning to
				ElderChoices.
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Scope of Services
ElderChoices
: Services available
				through this program include:
Homemaker Services
Chore Services
Home Delivered Meals
Personal Emergency Response System
Adult Day Health Care
Adult Foster Care
Respite Care
Adult Day Care
AAPD Waiver
: Services available
				through this program are available to a limited number of recipients and
				include:
*
.
Attendant Care
-
consumer directed/co-employer
-
traditional agency services
* Environmental Accessibility Adaptation Services
-
case management/counseling support
Both ElderChoices and AAPD Waiver recipients are eligible for
				the full range of Medicaid benefits. However, the individual must accept the
				services provided by the Waiver program for which they apply to be eligible for
				Medicaid. The need or desire for a Medicaid card only will not qualify an
				individual for eligibility.
Applicants for ElderChoices must be 65 years of age or older.
				Applications made by individuals who have not reached their
				65th birthday will be screened for AAPD Waiver
				eligibility.
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Eligibility Requirements
ElderChoices and AAPD Waiver share most eligibility
				requirements. To be eligible for either Waiver program, an individual must meet
				both the non-medical and medical criteria listed below:
I.
Non-Medical
			 Criteria
1. Income - Gross
			 income cannot exceed the current LTC income limit. (Re: SSI Chart at Appendix
			 S). Income is determined and verified according to LTC guidelines (Re. MS
			 3340-3348). VA A&A and CME/UME will be disregarded as income for
			 eligibility. The spousal rules for income do not apply to either AAPD or
			 ElderChoices as the individual makes no contribution toward the cost of care.
*
2.
			 Resources - Total countable resources cannot exceed the current LTC
			 limitations.
Resources are determined and verified according to LTC
				guidelines (Re. MS 3330). The spousal rules for resources at MS 3337 - 3338.12
				apply to ElderChoices and AAPD Waiver applicants and recipients.
The transfer of resource provisions will apply. If assets have
				been transferred during the look back period, a period of ineligibility for
				Waiver services will be imposed for uncompensated value.
3. Citizenship - It must be verified that the
			 individual is a citizen of the United States or a lawfully admitted qualified
			 alien (Re. MS 6700).
4. Residency -
			 The individual must be a resident of Arkansas (Re. MS 2200).
5. Social Security Enumeration - The
			 individual must meet the Social Security Enumeration requirement (Re. MS
			 1390).
6. Cost Effectiveness - The
			 average cost of services provided to individuals in the community must be less
			 than the cost of services for those individuals if they were in an institution.
			 This determination will be made by DAAS.
7. ElderChoices Recipients must be age 65 or
			 over. AAPD recipients must be age 21 through 64, and must be physically
			 disabled according to SSI/SSA guidelines.
* Once the AAPD recipient reaches age 65, the individual will
				have a choice to remain in the AAPD waiver or transition to
				ElderChoices.
Each eligibility requirement, with the exception of cost
				effectiveness, will be verified and documented in the case record at initial
				certification. It may be assumed by DCO that an individual applying for the
				ElderChoices or AAPD Waiver program will meet the cost effectiveness criteria.
				If at any time DAAS determines that cost effectiveness is not met, DCO will be
				notified by DHHS-3330 and the Waiver case will be closed.
NOTE
: Medicaid only cannot be provided
				to an individual who is eligible for a Waiver program but who is not receiving
				(or will not receive) Waiver services. When certifying a Waiver case, it may be
				assumed that there are Waiver services available in the area where the
				individual lives and that the individual will receive a Waivered service within
				a month of certification.
It is the responsibility of DAAS to ensure that Waiver services
				are available. If at any time a Waiver recipient is not receiving a Waiver
				service, DAAS will notify the DHHS county office via the DHHS-3330 so the
				Waiver case can be closed.