Act 1230 of 2001 authorized the creation of Assisted Living in Arkansas. Prior to Act 1230, Assisted Living was not mentioned in Arkansas law or regulation. This act created, within the Department of Human Services (DHS), an Assisted Living Program for the State of Arkansas. A copy of Act 1230 can be obtained at http://www.arkleg.state.ar.us/.

To provide Assisted Living in Arkansas, one must:

• Obtain a Permit of Approval from the Arkansas Health Service Permit Agency, and
• Obtain a License from the AR Department of Human Services Office of Long Term Care.

The Arkansas Health Service Permit Agency has adopted a Permit of Approval methodology. For information on how to apply for a Permit of Approval contact the:

Arkansas Health Services Permit Agency
Freeway Medical Tower
5800 West 10th, Suite 805
Little Rock, AR 72204
http://www.arhspa.org/

The Arkansas Department of Human Services (DHS) has issued Regulations for Assisted Living. DHS promulgated the regulations in accordance with the Arkansas Administrative Review Process, which included a 30-day public comment period.

Building an assisted living facility with rents in the $350-$400 per month range is indeed a challenging undertaking. It often requires the use of public financing mechanisms such as tax credits, HOME funds, bonds, Federal Home Loan Bank assistance, and other programs. Often these must be combined or "layered." The Arkansas Development Finance Authority has a set-a-side for affordable assisted living. Their Web page provides information on how to apply for tax credits and HOME funding.

Essential Links

Arkansas Development Finance Authority (ADFA)
Low Income Tax Credit and HOME Programs

Arkansas Health Services Permit Agency

Arkansas Medicaid, Office of Long Term Care Regulations

The Enterprise Social Investment Corporation Tax Credit 101

NCB Capital Impact

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Assisted Living Facility Regulations

To read and/or download the final regulations for both Level I and Level II Assisted Living Facilities in either Adobe Acrobat Reader .PDF or Microsoft Word .doc format, please visit the website of Arkansas Medicaid's Office of Long Term Care (OLTC).

Note: Upon accessing the OLTC website, in the left column scroll down to For Providers and click on Regulations. When the Regulations section appears on the larger right-hand portion of the screen, scroll down to find a table of various regulations. In that table, you will find the Level 1 and the Level 2 Assisted Living Facility regulations.

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• Aged persons (age 65 or over) or 21 years of age or over and blind or disabled
  
  
• Financial
• Monthly Income No More than 300% of SSI
• Resource Limit
  • $2,000 Individual
  • $3,000 Couple
    
    
• Meet Medical Criteria for Nursing Home Admission. The person must meet at least 1 of the following 3 criteria as determined by a licensed medical professional:
  • The person is unable to perform either of the following:
    • Requires extensive assistance from or total dependence upon another person in at least 1 of the following ADLs:
      • Transferring/Locomotion
      • Eating
      • Toileting, OR
    • Requires limited assistance from another person in at least 2 of the following ADLs:
      • Transferring/Locomotion
      • Eating
      • Toileting; OR
  • The person has a primary or secondary diagnosis of Alzheimer's disease or related dementia and is cognitively impaired so as to require substantial supervision from another person because he or she engages in inappropriate behaviors that pose serious health or safety hazards to himself or others; OR
    
    
  • The person has a diagnosed medical condition that requires monitoring or assistance at least once a day by a licensed medical professional, and the condition, if untreated, would be life threatening.

• Application originates in the DHS County Office where the assisted living facility that a person wants to reside is located
  
  
• Before application can be made at the DHS County Office, the assisted living facility where the person wants to reside must be contacted and a letter obtained indicating that if the person is found eligible for the assisted living waiver, there is an apartment available in the facility for that person. The person is to take this letter with them when he/she makes application for the Living Choices Assisted Living Wavier at the DHS County Office
  
  
• DHS County Office Eligibility Worker will take the application and determine financial eligibility and will send a referral to the DAAS RN
  
  
• DAAS will simultaneously collect information for subission to DMS OLTC for medical/nursing home admission and level of care eligibility determination and will complete an assessment and service plan
  
  
• DHS County Office will make the final eligibility determination and open the Medicaid case
  
  
• Eligibility is re-determined annually

• DAAS Employee
  
  
• Completes the Evaluation for Nursing Home Placement/Level of Care Eligibility
  
  
• Completes the Comprehensive Assessment and Establishes the Tier of Need
  
  
• Completes the Service Plan - Updates the Service Plan annually and at times of significant change

Services

1. Assisted Living Services that include:

• Attendant Care - Assistance with ADLs, mobility & transferring, assistance with toileting or incontinence care, assistance with eating & drinking, etc.
  
• Therapeutic Social and Recreational Activities
  
• Medication Oversight to the extent permitted under State law
  
• Medication Administration
  
• Periodic Nursing Evaluations
  
• Limited Nursing Services
  
• Non-Medical Transportation specified in the plan of care

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• Medicaid reimbursement to Living Choices Assisted Living Waiver "assisted living services" providers is a daily rate that corresponds to the tier of need in which the DAAS RN places a waiver participant. The determination of the tier of need is based on comprehensive assessment. There are four tiers of need. The daily rate pays for all direct care services in the waiver recipient's plan of care.
  
• DAAS will set the assisted living recipient's tier of need and rate for the waiver services in the MMIS system
  
• Medicaid reimbursement for pharmacist consultant services is a daily rate
  
• The assisted living waiver will pay for 3 prescription drugs beyond the Medicaid State Plan Prescription Drug Program's monthly benefit limit and extension of that monthly benefit limit.
  
• Persons approved for Assisted Living Waiver services may not receive Medicaid State Plan Personal Care
  
• Reimbursement is for services only; room and board (rent) are to be paid by the client or his or her legal representative.
  

Questions?

Call or email LeAnn Edwards if you have questions.
Division of Aging and Adult Services

501-682-2441
TDD: 501-682-2443
Fax: 501-682-8155

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DAAS Home Page

This page was created by Ron Tatus and updated on 4/29/2008