Arkansas CES Waiver: Eligibility, Application, and Waitlist Guide

The Community and Employment Support (CES) waiver is the primary Medicaid 1915(c) waiver for adults with intellectual and developmental disabilities in Arkansas. For families navigating the IEP-to-adulthood transition, understanding the CES waiver pipeline is critical — because it operates on a completely different system than the school-based services your family already knows.

The IEP is an entitlement. If your child qualifies, the school district must provide services. The CES waiver is not. It is capped at 8,233 active slots statewide, and when those are full, eligible applicants go on a waitlist that has historically stretched up to 11 years.

Who Qualifies for the CES Waiver

The Division of Developmental Disabilities Services (DDS) Psychology Team evaluates four criteria for clinical eligibility:

1. Qualifying diagnosis — intellectual disability, cerebral palsy, epilepsy, autism, Down syndrome, spina bifida, or a closely related condition
2. Age of onset — the disability manifested before the applicant's 22nd birthday
3. Indefinite duration — clinical expectation that the disability and associated deficits will continue indefinitely
4. Functional deficits — documented substantial limitations in at least three of six major life areas: self-care, language, learning, mobility, self-direction, or capacity for independent living

The CES waiver uses the Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID) level-of-care standard. Having an IEP does not automatically meet this threshold — many students with learning disabilities, ADHD, or mild intellectual disability will not qualify.

How to Apply

The CES waiver application is completely separate from your child's IEP transition plan. The school district cannot apply on your family's behalf.

Step 1: Submit a referral through the DHS DDS online intake portal or contact DDS Intake and Referral at 501-683-5687.

Step 2: Complete the DCO-0004 form (long-term care Medicaid application) through the Division of County Operations.

Step 3: Provide diagnostic documentation. This is where many families hit a bottleneck. Under Act 656 of 2021, psychological evaluations for waiver eligibility must come from a restricted list of "Qualified Providers" — which excludes Licensed Psychological Practitioners (LPPs). Because roughly 40% of Arkansas counties lack a registered psychologist, families can wait 12 to 18 months just for a diagnostic appointment.

Step 4: Undergo an Independent Assessment (IA) conducted by Optum to determine your tier level. Individuals assessed at Tier 2 or Tier 3 are assigned to a Provider-Led Arkansas Shared Savings Entity (PASSE).

The Waitlist: What to Expect

As of July 2026, approximately 2,268 individuals were on the CES waiver waitlist. Those at the top had waited roughly three years. Historically, the waitlist has exceeded 4,500 people.

The single most important thing to know about the waitlist: DDS sends an annual verification letter to the address on file. If your family fails to respond to this letter, your child is immediately removed from the waitlist and your application date is permanently forfeited. There is no grace period and no reinstatement — you go back to the end of the line.

Apply as early as possible. The waitlist clock starts from the application date, not from high school graduation.

PASSE Care Coordination

Once your child is approved for the waiver (or added to the waitlist with active Medicaid), the four active PASSE organizations — Arkansas Total Care, CareSource, Empower Healthcare Solutions, and Summit Community Care — manage service delivery.

Within 15 business days of enrollment, a PASSE Care Coordinator must contact your family. The coordinator handles:

• Developing the annual Person-Centered Service Plan (PCSP)
• Authorizing funding for supportive living, transportation, specialized medical supplies, and job coaching
• Monthly check-in contacts and quarterly face-to-face meetings

The Care Coordinator is your family's primary point of contact for navigating adult services after the school system's obligation ends.

Timing the Application Around the IEP Timeline

The best time to submit a CES waiver application is during the age 17–18 IEP meeting cycle. Screen for eligibility at age 17, apply at 18, and get on the waitlist while your child still has school-based services as a safety net.

If your child is on the Alternate Pathway to Graduation, they can continue receiving school services through the end of the school year in which they turn 21 — buying additional time while the waitlist moves.

The Arkansas IEP Transition to Adulthood Guide walks through the complete CES waiver application sequence alongside the IEP transition timeline, with tracking worksheets for your waitlist status, DDS correspondence, and PASSE enrollment milestones.

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