Medicaid, ARHOME, and ARKids Clients

Make sure your mailing address and phone number is up-to-date. Don’t miss important renewal information.

Self-Direction/Independent Choices

Self-Direction/Independent Choices

Self-directed Medicaid services means that participants, or their representatives (if applicable), have decision-making authority over certain services and take direct responsibility to manage their services with the assistance of a system of available supports. The self-directed service delivery model is an alternative to traditionally delivered and managed services, such as an agency delivery model. Self-direction of services allows participants to have the responsibility for managing all aspects of service delivery in a person-centered planning process.

Self-direction promotes personal choice and control over the delivery of waiver and state plan services, including the choice of who provides the services and how services are provided. In the state of Arkansas, there are currently two (2) programs offering the self-direction model:

  • IndependentChoices (1915i State Plan Services)
  • ARChoices (1915c HCBS Waiver Services)

Participants on either of these programs choosing the self-direction model are afforded the responsibility to recruit, hire, train and supervise the individuals who furnish their services. The Centers for Medicare & Medicaid Services (CMS) calls this “employer authority.” Participants may also have decision-making authority over how the Medicaid funds in a budget are spent. CMS refers to this as “budget authority.”

Self-direction services give Medicaid recipients another choice of how to receive personal assistance services in their home.  Participants and/or representatives have more control of how their personal assistance needs are met. They receive a cash allowance for their personal care assistance services and can decide how it will be spent.  They may choose to use their entire allowance to pay their personal assistant or choose to use part of their allowance to purchase other items that support their care and independence.

With self-direction, the participant/representative decides:

  • Who provides their care
  • When their personal assistant works
  • What their personal assistant does for them
  • How their personal assistant takes care of them
  • What other items they need to enhance their quality of care and independence

There is also more responsibility when participating in a self-direction program.  These responsibilities include:

  • Hiring or firing their personal assistant
  • Directing their personal assistant on how they would like things done
  • Scheduling when the personal assistant comes to their home
  • Keeping up with when the personal assistant works and approving their time
  • Possibly keeping up with receipts if they choose to use part of their cash allowance to purchase items

Participants using the self-direction model will work with a Financial Management Service (FMS) vendor who has contracted with DHS. The FMS vendor is not a provider and does not have Employer Authority. This FMS vendor assists individuals in exercising their budget authority, such as:

Understanding billing and documentation responsibilities

  • Performing payroll and employer-related duties such as withholding and filing federal, state, local and unemployment taxes
  • Purchasing workers’ compensation or other forms of insurance
  • Collecting and processing worker timesheets
  • Calculating and processing employee benefits
  • Issuing payroll on behalf of the employer/participant
  • Purchasing approved goods and services
  • Tracking and monitoring individual budget expenditures
  • Identifying expenditures that are over or under the budget

DHS is currently contracted with Palco, Inc. as the FMS vendor for the state of Arkansas. See our Financial Management Services page for more detail.

ELECTRONIC VISIT VERIFICATION (EVV)
See our self-direction EVV page for more detail.

PROVIDER MANUALS
IndependentChoices

ARChoices in Home Care Home and Community-Based 2176 Waiver

DPSQA Address

700 Main Street Slot S-427
Little Rock, AR  72203-1437 

DPSQA Phone Number

501-682-2441

Learn About Programs

Apply For Services

Find Service Providers

Do Business With DHS

Become A Provider

Report A Concern

Copyright 2022 © All Rights Reserved. Arkansas.gov