Key takeaway
Arkansas pays family caregivers primarily through the ARChoices waiver and the Independent Choices self-directed Medicaid program. Spouses and legal guardians cannot be paid under Medicaid; VA Veteran Directed Care may pay spouses.
- Medicaid: ARChoices in Homecare waiver funds personal care, respite, and home modifications.
- Independent Choices: Arkansas’s Cash & Counseling–style program lets the participant hire family caregivers.
- AR Personal Care: state plan personal care available without a waiver, with consumer-directed options through Independent Choices.
- Veterans: Aid & Attendance and Veteran Directed Care fund family caregiving (VDC can pay spouses).
Overview
Arkansas offers a clear set of paths for getting paid to care for a family member at home. The Arkansas Department of Human Services (DHS), Division of Aging, Adult, and Behavioral Health Services (DAABHS) and Division of Medical Services administer the main programs. Most options require the care recipient to meet a nursing-facility level of care and to qualify financially.
The most common avenue for paid family caregiving in Arkansas is the Independent Choices program — a self-directed Medicaid option that gives the participant a monthly cash budget to hire and supervise their own caregiver, typically an adult child, sibling, or friend. Spouses and legal guardians are not allowed under Medicaid options but may be paid under the VA’s Veteran Directed Care program.
Programs that pay family caregivers in Arkansas
| Program (Type) | Care recipient eligibility | Paid family caregiver provisions |
|---|---|---|
| ARChoices in Homecare Waiver (Medicaid HCBS) | Age 21+ with a physical disability or age 65+; meets intermediate or skilled nursing-facility level of care; Medicaid financial limits apply. | Funds attendant care, home-delivered meals, respite, adult day services, and minor home modifications. Family (not spouses or legal guardians) may be hired through Independent Choices. |
| Independent Choices (Self-directed Medicaid) | Medicaid-eligible adults who are approved for AR Personal Care or ARChoices and want to self-direct. | Provides a monthly cash allowance the participant uses to hire and pay their own caregiver. Adult children, friends, and relatives can be hired; spouses and legal guardians cannot. |
| AR Personal Care (Medicaid State Plan) | Medicaid-eligible Arkansans with a medical need for hands-on personal care; physician order required. | Pays for ADL/IADL help through agencies or, via Independent Choices, through a family caregiver. |
| Aid & Attendance Pension (VA benefit) | Wartime veteran or surviving spouse with limited income/assets and a documented ADL need. | Increases monthly pension; veteran can pay an adult child or relative. Spouses cannot be paid directly. |
| Veteran Directed Care (VDC) (VA program) | Veteran enrolled in VA health care who meets nursing-home level of care; must live in an area served by a participating VAMC. | Monthly care budget to hire any caregiver, including a spouse. VDC is offered through several Arkansas VAMCs. |
| Long-Term Care Insurance (Private) | Policy must cover in-home personal care and pay benefits to the policyholder. | If allowed, the care recipient can use benefits to pay a family caregiver directly. |
Arkansas Medicaid programs
Arkansas Medicaid pays family caregivers primarily through the ARChoices in Homecare waiver and the Independent Choices self-direction program, layered on top of either ARChoices or the AR Personal Care state plan benefit. Spouses and legal guardians cannot be paid through any of these options.
ARChoices in Homecare Waiver
ARChoices is Arkansas’s primary HCBS waiver for older adults and adults with physical disabilities who would otherwise need a nursing facility. Services include attendant care, home-delivered meals, personal emergency response systems, respite, adult day services, and home modifications.
- Age 65+ or adults 21+ with a qualifying physical disability.
- Must meet intermediate or skilled nursing-facility level of care.
- Income limit generally at or below 300% of the SSI federal benefit rate; asset limit $2,000 (individual).
- Family (except spouses and legal guardians) may be paid through Independent Choices.
AR Personal Care
AR Personal Care is the Medicaid state plan benefit that covers help with ADLs and IADLs for Medicaid recipients with a physician-documented need. It does not require a waiver and is available to any Medicaid-eligible Arkansan with a medical need for personal care.
- Physician order plus DHS assessment required.
- Covered tasks include bathing, dressing, toileting, transfers, meal prep, and light housekeeping.
- Independent Choices participants can self-direct AR Personal Care hours.
Independent Choices (self-direction)
Independent Choices is Arkansas’s Cash & Counseling–style program. Instead of receiving services from an agency, the participant gets a monthly cash budget to design their own care plan and pay their own caregiver — typically an adult child, sibling, or friend.
- Participant becomes the employer of record; a fiscal agent handles payroll, taxes, and timesheets.
- A counselor helps draft a spending plan that fits the assessed care needs.
- Spouses and legal guardians cannot be hired and paid under Independent Choices.
State-funded supports through DAABHS and Area Agencies on Aging
Beyond Medicaid, Arkansas’s Division of Aging, Adult, and Behavioral Health Services (DAABHS) and its network of eight Area Agencies on Aging (AAAs) coordinate non-Medicaid supports for caregivers. These programs usually fund respite and training rather than a direct caregiver wage.
Federally funded program offering information, counseling, training, respite, and supplemental services to family caregivers of older adults.
Statewide help line and Aging and Disability Resource Center that connects families with home and community-based options.
Who qualifies
- Family caregivers of adults age 60+ or of any age with Alzheimer’s or related dementias.
- Grandparents 55+ raising grandchildren.
- Many services are not income-tested but may prioritize low-income, rural, or minority households.
Veterans’ programs
Arkansas has approximately 200,000 veterans. The most common VA pathways for paying family caregivers are Aid & Attendance, Veteran Directed Care, and PCAFC.
Aid & Attendance Pension
A&A is a monthly add-on to the VA pension for wartime veterans or surviving spouses who need help with daily activities. The veteran can use the funds to pay an adult child or relative for care.
- Qualifying wartime service, limited income/assets, and documented ADL need.
- Spouses cannot be paid directly because household income is combined.
Veteran Directed Care (VDC)
VDC provides a monthly care budget the veteran manages to hire caregivers, including a spouse or adult child. The Central Arkansas Veterans Healthcare System and Fayetteville VA Healthcare System participate.
- Veteran must meet nursing-home level of care.
- Spouses may be paid caregivers under VDC.
- Financial management service handles payroll.
Program of Comprehensive Assistance for Family Caregivers (PCAFC)
PCAFC provides a monthly stipend, training, and other supports to the primary family caregiver of an eligible veteran with serious injury or illness.
- Stipend tier depends on the veteran’s assessed needs.
- Apply through the VA Caregiver Support Program.
Long-term care insurance
If the care recipient owns a long-term care insurance policy, benefits may be used to pay a family caregiver, subject to policy terms.
What to check in the policy
- Coverage includes in-home personal care, not just facility care.
- Benefits pay the policyholder directly (cash/indemnity model) so they can pay a family caregiver.
If the policy only reimburses licensed agencies, the family caregiver may need to work through an Arkansas-licensed home care agency that bills the policy.
How to apply in Arkansas (step-by-step)
- Identify your most likely path: ARChoices, Independent Choices, AR Personal Care, VA benefits, or LTC insurance.
- Gather documents: photo ID, Social Security card, proof of Arkansas residency, income/asset documentation, medical records, current medications list, and (for veterans) DD-214.
- Start with the right agency:
- ARChoices: call the Arkansas DHS Choices in Living Resource Center at 1-866-801-3435 to request an assessment.
- Independent Choices: ask your DHS county office or the Independent Choices Counselor about enrollment after AR Personal Care or ARChoices approval.
- AR Personal Care: obtain a physician order and contact DHS for a personal care assessment.
- VA paths (A&A, VDC, PCAFC): contact the VA Caregiver Support Line at 1-855-260-3274 or the social work team at Central Arkansas Veterans Healthcare System or Fayetteville VA.
- LTC insurance: call the insurer to confirm caregiver payment rules and documentation.
- Complete required assessments — functional level of care and Medicaid financial eligibility.
- Enroll in Independent Choices if you want to self-direct, then designate your family caregiver and complete the fiscal agent paperwork.
- Begin services. Submit timesheets, keep care logs, and prepare for annual reassessment.
Arkansas paid caregiver FAQs
Can a spouse be paid as a caregiver in Arkansas?
Not under Arkansas Medicaid options like ARChoices, AR Personal Care, or Independent Choices — spouses and legal guardians are excluded. Spouses can be paid through the VA’s Veteran Directed Care program if the veteran qualifies and lives in an area served by a participating VAMC.
How much do caregivers get paid in Arkansas?
Caregiver pay under Independent Choices is set within the participant’s monthly cash budget and typically ranges from about $10 to $13 per hour, depending on the care plan. VA Veteran Directed Care budgets vary by assessed needs.
Can I be paid to care for my parent in Arkansas?
Yes. Adult children are commonly hired through ARChoices with Independent Choices, AR Personal Care with Independent Choices, and VA programs such as Aid & Attendance and Veteran Directed Care.
What is Arkansas Independent Choices?
Independent Choices is Arkansas’s self-directed Medicaid program. The participant receives a monthly cash allowance instead of agency-provided services, and uses it to hire and supervise their own caregiver — usually a friend or relative other than a spouse or legal guardian.
Is there a waitlist for ARChoices?
ARChoices enrollment has had waitlists in the past depending on funding. While waiting, ask DHS about non-Medicaid bridge supports through your Area Agency on Aging or the AR Personal Care state plan benefit if eligible.
