Arkansas Administrative Code › Agency 016 - DEPARTMENT OF HUMAN SERVICES › Division 06 - Medical Services › Rule 016.06.09-045 - State Plan Amdndment #2009-013 and Independent Choices #18

Current through Register Vol. 49, No. 6, June, 2024
Section
			 IIndependentChoices
200.100
IndependentChoices
The Arkansas Department of Human Services (DHS) was granted an
				1115 Research and Demonstration waiver to implement IndependentChoices, a Cash
				and Counseling Demonstration and Evaluation Project in 1998. On April 1, 2008,
				the IndependentChoices program became a state plan service under 19150 of the
				Social Security Act. IndependentChoices is operated by the Division of Aging
				and Adult Services (DAAS). The program offers Medicaid-eligible aged and
				disabled individuals an opportunity to self-direct their personal assistant
				services.
The IndependentChoices program has been operational since 1998.
				Some of the results of evaluations performed by Mathematica Policy Research,
				Inc. specifically identified these results that may positively impact community
				services in Arkansas:
A.
			 IndependentChoices decreased unmet needs.
B. IndependentChoices improved
			 lives.
C. IndependentChoices
			 participants were less likely to have contractures or urinary tract infections
			 develop or worsen.
D. Nursing home
			 costs decreased by 18% over a three year period for IndependentChoices
			 participants.
Operation of the IndependentChoices program as a state plan
				service will use the positive foundation established through lessons learned as
				an 1115 Research and Demonstration Waiver to continue to offer opportunities
				for improved life in the community.
IndependentChoices seeks to increase the opportunity for
				consumer direction and control for Medicaid beneficiaries receiving or needing
				personal assistant services. Personal Assistant services in IndependentChoices
				include state plan personal care for Medicaid beneficiaries and Adult Companion
				and Homemaker services for ElderChoices beneficiaries. IndependentChoices
				offers an allowance and counseling services in place of traditional
				agency-provided personal assistance services and items related to personal
				assistance needs.
The participant or designee is the employer and accepts the
				responsibility in directing the work of their employee to the degree necessary
				to meet their individual needs for assistance with activities of daily living
				and instrumental activities of daily living.
If the IC participant can make decisions regarding his or her
				care but does not feel comfortable reading and filling out forms or talking on
				the phone, he or she can appoint a Communications Manager. The Communications
				Manger can act as the participant's voice and complete and sign forms, etc.,
				but will not make decisions for the participant. The Communications Manager
				will not hire, train, supervise or fire the personal assistant for the IC
				participant.
If the participant needs someone to hire and supervise the
				personal assistant, make decisions about care and administer the cash
				expenditure plan as well as complete all forms, a Decision-Making Partner will
				be appointed.
IndependentChoices participants or their Decision-Making
				Partners must be able to assume the responsibilities of becoming an employer by
				hiring, training, supervising and firing if necessary their directly hired
				workers. In doing so the program participant accepts the risks, rights and
				responsibilities of directing their care and having their health care needs
				met.
The IndependentChoices program respects the employer authority
				of the Medicaid beneficiary who chooses to direct his or her care by hiring an
				employee who will be trained by the employer or Decision-Making Partner to
				provide assistance how, when, and where the employer or Decision-Making Partner
				determines will best meet the participant's individual needs. The Medicaid
				beneficiary assumes the risks, rights and responsibilities of having their
				health care needs met in doing so.