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Arkansas - Respite Care Services — Licensing, Medicaid Enrollment and Startup Requirements

Last reviewed: 2026-08-16

In Arkansas, Respite Care Services provide short-term, temporary relief to unpaid primary caregivers, ensuring the Medicaid participant continues to receive necessary supervision and support. This service is primarily funded through Home and Community-Based Services (HCBS) waivers, specifically the ARChoices in Homecare Waiver for adults with physical disabilities and the Community and Employment Support (CES) Waiver for individuals with intellectual and developmental disabilities.

The single biggest structural barrier to entry in Arkansas is that the state does not issue a standalone "Respite Care License." Instead, applicants must first obtain an underlying state license (such as a Class A or Class B Home Health Agency or Home Care Agency license) or achieve comprehensive CES Waiver Provider Certification through the Division of Provider Services and Quality Assurance (DPSQA) before they are permitted to enroll in Medicaid to bill for respite services.

1. Service Definition and Scope

Respite care in Arkansas is defined as short-term relief provided to an unpaid primary caregiver. It ensures that the participant's health, safety, and supervision needs are met while the caregiver is temporarily unavailable. The service is authorized under specific Medicaid waivers, including the [AR Choices in Homecare Waiver (0195.R06.00) | Medicaid](https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/81001).

Services can be delivered in the participant's home, the provider's home, or an approved licensed facility. The scope of care includes assistance with activities of daily living (ADLs), supervision, and basic health monitoring, but it cannot replace routine nursing care.

2. Regulatory and Oversight Agencies

The Arkansas Department of Human Services (DHS) is the single state Medicaid agency responsible for overseeing HCBS waivers. Within DHS, the Division of Provider Services and Quality Assurance (DPSQA) handles provider certification, licensing, and quality surveys.

The Division of Medical Services (DMS) manages the actual Medicaid provider enrollment process and claims payment, utilizing Gainwell Technologies as the fiscal agent to operate the Medicaid Management Information System (MMIS).

3. Gatekeeping Prerequisites: Who Can Even Apply

Arkansas does not utilize a Certificate of Need (CON) program or closed network procurement (RFP) for respite care. However, it strictly enforces an operational prerequisite: you cannot apply to Medicaid as a standalone "respite provider."

To bill for respite under ARChoices or the CES Waiver, an applicant must first hold an underlying state license (such as a Home Health or Home Care license) or pass the rigorous DPSQA certification process to become a comprehensive waiver provider. There are currently no state-imposed moratoria on new HCBS waiver provider enrollments.

4. Licensure and Certification Requirements

Because respite is a service rather than a facility type, providers must achieve DPSQA certification for the specific waiver they intend to serve. For the CES Waiver, this involves a rigorous application process demonstrating the capacity to serve individuals with intellectual and developmental disabilities.

Applicants must submit detailed organizational policies, prove financial solvency, and undergo an initial readiness review by DPSQA surveyors before certification is granted.

5. Medicaid Provider Enrollment

Once certified by DPSQA, providers must enroll with Arkansas Medicaid through the Division of Medical Services (DMS). This process is managed by Gainwell Technologies via the MMIS Provider Portal.

Providers must submit specific state forms and pay the federal application fee to receive their Medicaid Provider ID, which is required to bill for services.

6. Staffing, Training and Background Checks

Direct care workers providing respite must meet strict state background check and training standards. Agencies are responsible for maintaining these compliance records in individual personnel files.

Arkansas law mandates clearance through multiple state registries before a worker can have direct contact with a Medicaid participant.

7. Documentation, Policies and Records

Arkansas DHS requires providers to maintain comprehensive records to justify Medicaid billing. All service documentation must align strictly with the participant's authorized Person-Centered Service Plan (PCSP).

Providers must also maintain robust internal policies for incident reporting and emergency backups to ensure participant safety during service delivery.

8. Billing, Rates and Claims

Respite services are billed to Arkansas Medicaid via the MMIS portal. Rates are established by DMS and are typically billed in 15-minute increments or on a per diem basis, depending on the specific waiver rules.

In-home respite services are subject to federal Electronic Visit Verification (EVV) requirements, meaning providers must use an approved system to capture the time and location of service delivery.

9. Approval Sequence and Timeline

The process to become a fully billing respite provider in Arkansas is sequential and can take several months. Certification by DPSQA must precede Medicaid enrollment with DMS.

Applicants should expect a multi-step process involving business setup, state surveys, and portal onboarding before they can accept their first Medicaid client.

10. Common Denials and Survey Findings

Applications and ongoing certifications are frequently delayed or denied due to incomplete documentation or failure to meet strict background check requirements.

During DPSQA surveys, providers are often cited for failing to align their service delivery with the authorized PCSP or for lapses in EVV compliance.

11. Key Contacts and Resources

Prospective providers should utilize the official DHS portals and contact the specific divisions for guidance during the application process.

The Arkansas Foundation for Medical Care (AFMC) is also a valuable resource for MMIS support and provider education.

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