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Frequently Asked Questions |
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Frequently Asked Questions |
Independent Choices is a research project funded by the Robert Wood Johnson Foundation (a private organization) and the U.S. Department of Health & Human Services. This project will create a new way of helping persons in their homes receive personal assistance. Eligible Arkansas Medicaid persons who are willing and selected will exchange their agency personal care services for a cash allowance. Participants will use the cash allowance to purchase their own personal assistance services.
Participants decide how their personal assistance needs should be handled. So long as purchases relate to personal assistance or enhance a person's independence, the cash allowance may be spent. Friends, neighbors or relatives (except legal guardians and spouses) may be hired to provide personal assistance, or items or services related to personal assistance may be purchased.
Persons who qualify and are interested in IndependentChoices will be given an opportunity to enroll. Interested persons contact the IndependentChoices toll free number. Once the person's information is entered into the IndependentChoices database it is then referred to a Counseling Fiscal Agent (CFA). The CFA is a DHS Contractor who acts as a partner in not only helping the person establish consumer direction but also explaining how IndependentChoices works and answering questions as they may arise.
If a person is 18 years of age or older, currently receives Medicaid benefits, is in need of personal care assistance, capable of self-directing or have an appropriate representative, and is willing to participate, they may enroll at any time.
The amount of the cash allowance is based on a formula considering the number of hours of personal care prescribed each month to the number of hours of personal care actually delivered.
Only Medicaid Personal Care hours will be affected. Other Medicaid services including waiver services will remain unchanged.
Persons enrolled in IndependentChoices may return to the traditional Personal Care Program any time they wish. Assistance is available to each participant with the transition back to traditional services.
New organizations have been created to support IndependentChoices participants. These agencies will help teach about consumer-direction and self-management. A counselor is available to guide and support in managing the cash allowance and to offer suggestions on the use of the cash allowance. Assistance with the required payroll and bookkeeping tasks is also available.
Experience has proven that many clients of Medicaid Personal Care are very satisfied with the present service delivery method. Many commonly expressed reasons for disinterest include "Don't know who they would hire", "I like my aide", "Too much paperwork", and "Cash allowance too low".
During the development stages of the project, research was done to determine the payroll liabilities of the sate agency, the participant and the attendant. According to the Internal Revenue Services, if an individual controls the work being performed and how it is performed, the worker is an employee rather than an independent contractor. Because the IndependentChoices participant is in control of who they hire and what assistance they provide, the participant becomes the employer of record and is responsible to report and pay a portion of Social Security and Medicare and Unemployment Insurance (state and federal). The participant must also verify citizenship and report wages to the state and federal Internal Revenue Service. In some states, Worker's Compensation is an issue but not in Arkansas. The assistant must pay a portion of Social Security and Medicare and report earnings to the state and federal Internal Revenue Service.
Enrollment began December of 1998 and will continue through September 2006. It is anticipated that enrollment will continue beyond 2006 as the program is well received.
Additional information may be obtained by calling the toll-free number 1-888-682-0044. A representative of IndependentChoices Project may be available to answer any questions. During closed hours or if the line is busy, a person may leave a message and the call will be returned. If interest continues, a referral will be made to a Counseling Fiscal Agency (CFA). The CFA is a department of Human Services contactor who assists the Division of Aging and Adult Services and participants who wish to replace agency personal care with a cash allowance. The CFA initiates the enrollment process into consumer direction and serves as partner with the participant in consumer-direction.
