Why Hasn’t the Community First Choice Option Been Implemented in Arkansas Yet?

As need for more community-based services grows in Arkansas, state legislators have yet to implement a new plan that could help.

Arkansas is one of a few states that decided several years ago to start developing a plan for implementing the Community First Choice option, which is part of a Medicaid program created by the Affordable Care Act. Under this program, the availability of home and community-based services in Arkansas would be expanded, offering more choice to those in need of these programs. However, in the past five years, no steps have been taken to pass legislation in Arkansas for this program. With thousands of Arkansans on a waiting list for care, why hasn’t the program moved forward?

What Is the Community First Choice Option?

The Community First Choice option allows states to receive increased Medicaid dollars and support more beneficiaries through state-approved community-based service providers. In essence, it gives the beneficiary in need the right to choose their own care and choose who cares for them. This follows recent trends in Medicaid expenditures that have worked to support home and community-based services over institutional services to offer beneficiaries more independence and a greater quality of life.

Community First Choice would be positive for Arkansas Medicaid beneficiaries as it would them to receive treatment from their home or participate in community-based programs designed for adults with disabilities. Studies show that this kind of program would actually save tax money and be less expensive for caregivers than having their loved one institutionalized.

Lower-Cost, Long-Term Care Alternatives

When you break down the costs of such as program, the actual cost per capita is far less than care provided at private institutions. The average cost of elder care in a nursing home is almost $64,000 versus home and community-based services that cost a little bit more than $27,000.

There are nearly 3,000 Arkansans on the waiting list for home and community-based care. The portion of waiver care programs created for individuals with developmental disabilities has been capped in Arkansas, putting these individuals on an eight-year waiting list before they can participate in these programs. By adding a program like the Community First Option in Arkansas, more Arkansans could come off the waiting list because funding for the services they need would increase availability.

Legislative Conflict in Arkansas

With all things considered, there are several reasons for why Community First Choice has not been implemented in Arkansas yet. First, the Community First Choice option was introduced under Obamacare, which is unpopular with the state legislature. Second, the privatization of Medicaid is a larger issue, as the Community First Choice Option would work well with privatization. Arkansas Republicans and Democrats are split on this issue. The nursing home industry has also lobbied against implementing the Community First Choice option.

The legislature charged consultants to prepare a report in 2015 that would help inform potential health reform in Arkansas. Consultants from The Stephen Group provided this report in October and recommended continuing the private option with certain adjustments. With this new information, a new plan was supposed to be drawn up during the last legislative session to remove the state’s waiting list, even if that meant implementing a program other than Community First Choice. Such reform has not taken place yet.

State health care programs are constantly changing with legislation, making it the role of service providers and task forces across the state to keep up with these changes and advocate for their patients. If your loved one is in need of community-based services in Little Rock, contact Integrity, Inc. at 501-406-0442 to learn more about our programs.

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Image licensed by Daniel Schwen

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