1. (a)

   1. (1) Arkansas Rehabilitation Services will purchase attendant services, in accordance with informed choice provided by one (1) or more persons, designed to assist an individual with disabilities to perform daily living activities in one (1) or more of a work, home, or community environment that the individual would typically perform if the individual did not have a disability.
   2. (2) These services may be provided to an individual at any time during the rehabilitation process when prescribed by an attending physician.
   3. (3) An attendant can be someone unrelated to the individual or a family member.
   4. (4) Rules for attendant qualifications are set by the state.
   5. (5) The individual must apply for a Medicaid waiver.
   6. (6) Arkansas Rehabilitation Services will pay based on Medicaid rates.

   7. (7)

      1. (A) Nonmedical services supporting activities of daily living, such as:

2. (i) Movement;

   1. (ii) Bathing;

      1. (iii) Dressing;

         1. (iv) Toileting; and
         2. (v) Personal hygiene.
      2. (B) Instrumental activities of daily living include meal preparation, money management, shopping and telephone use, etc.
   2. (8) Disability expected to continue indefinitely and disability constitutes a substantial limitation to person’s ability to function without supports existing with concurrent deficits in activities of daily living.
   3. (9) Recertification of services annually, prescribed by an attending physician, including an adaptive functional level assessment.
   4. (10) Weekly supports that may be needed daily but no more than eight (8) hours/day and seven (7) days a week.
   5. (11) Supports are not long term, provided for a maximum of six (6) months per calendar year with required outcome of employment with an allowable extension of sixty (60) days, post-employment.
   6. (12) Services will be rendered within an allowable forty-hour work week, with submission of timesheets reflecting hours worked.
   7. (13) Maximum reimbursement one hundred sixty dollars ($160)/day.
   8. (14) Individuals or their representatives have decision-making authority over personal attendant services and take direct responsibility to manage their services with assistance of a system of available supports.
   9. (15) A qualified personal attendant services agency and/or individual hires, fires, pays, and trains PAs to provide services to individuals.

3. (b) Procedures — Attendant services.

   1. (1) Documentation of the action to be taken will be made in the case note.

   2. (2)

      1. (A) Medical consultant’s review is required and attached to the ECF.
      2. (B) See Forms, Appendix E.
   3. (3) Refer to the Arkansas Rehabilitation Services vendor list or secure W-9 from new vendor.
   4. (4) The case management system will generate the status moves after required data is keyed for appropriate status.
   5. (5) Key required information into the case management system for Arkansas Rehabilitation Services purchase authorization.

   6. (6)

      1. (A) When billing statement is received, verify the individual received the service.
      2. (B) Document in the ECF.

   7. (7)

      1. (A) Key required information into the case management system for payment.
      2. (B) Support staff will be responsible for making payments.
      3. (C) Payment will not be processed without an attached bill from the vendor.

Codification Notes: “ECF” means electronic case file. "PA" means personal attendant.