Since 1959, Bost has been providing choices and opportunities in Western Arkansas for individuals with developmental and related disabilities so that they may live, work and play in the community.

Waiver (Medicaid / ACS)


The Bost Waiver Program currently serves over 400 children and adults with developmental disabilities.

The nation's Medicaid Waiver Program was developed to provide the in-home and in-community support needed by persons who are at risk of institutionalization.  Bost's Waiver Program currently serves over 400 individuals with disabilities in 28 counties in Western Arkansas.


The ACS (Alternative Community Services) Waiver is a state and federally funded program for individuals with developmental disabilities with an age of onset before the age of 22.

The Waiver is an alternative to institutionalization. An individual in the ACS Waiver lives as independently as possible in the community (the least restrictive setting) with Waiver services and other supports-instead of living in an institution (a restrictive setting).

Statewide, approximately 3850 persons were receiving ACS Medicaid Waiver Services as of May 2009. Bost is one of the largest providers of ACS Medicaid Waiver services in Arkansas. Applications are made through the Arkansas Department of Human Services. www.arkansas.gov Unfortunately, State funding for this program is limited which has resulted in a waiting list for the program.


The following services are available through the Waiver program:

  • Supported Living Services

Provides direct care staff to work in the individuals home and community on goals and objectives desired by the individual that were identified in the MAPS (Multi-Agency Plan of Service). Supported Living helps individuals to develop and keep and/or improved the self-help, socialization and adaptive skills necessary to live successfully in their home and community, with their family or in an alternate living residence or setting.

  • Community Experiences

Provide services where individuals work towards goals that reflect their interests. They are used to help improve community acceptance, employment opportunities and general well-being.

  • Non-Medical Transportation

Enables individuals to gain access to Waiver and other community services, activities and resources activities and resources planned for must be identified and specified in the plan of care.

  • Case Management

A system of ongoing monitoring of the provision of services included in the waiver participant's multi-agency plan of care. Case managers initiate and oversee the process of assessment of the individual's level of care and the review of plan of care at specified reassessment intervals.

  • Consultation

Assists individuals, parents and/or guardians and/or responsible individuals, community living services providers and alternative living setting providers in carrying out an individual's service plan.

  • Organized Health Care Delivery System (OHCDS)

Allows waiver providers to sub-contract any service for which they are DDS enrolled. A written contract is required. It is the responsibility of the provider to line up sub-contractors, bids and bill for the service. These services must be prior-approved by DDS.

  • Adaptive Equipment

Provides for the purchase, leasing and repair of adaptive, therapeutic and augmentative equipment. This equipment must be required for the individual to increase, maintain or improve their ability to perform daily life tasks.

  • Environmental Modifications

Adaptations to the individual's place of residence (structure). They must be to ensure the health, welfare and safety of the individual or enable the individual to function with greater independence.

  • Specialized Medical Supplies

Items necessary for life support and the supplies and equipment necessary for the proper functioning of such items. Non-durable medical equipment not available under the Medicaid State Plan may also be provided.

  • Supplemental Supports

Assist an individual to live in the community and participate in leisure, recreational, social and educational activities that make a positive difference their life.

  • Personal Care Services

Personal care includes hands-on assistance with bathing, bladder and bowel requirements, dressing, eating, incidental housekeeping, laundry, personal hygiene, shopping for personal maintenance items, medication, and mobility/ambulation.

  • Community Transition Services

Non-recurring set-up expenses for individuals who are transitioning from an institutional or another provider- perated living arrangement to a living arrangement in a private residence where the person is directly responsible for his or her own living expense.

One of the most important features of the Medicaid Waiver Program is the Personal Plan of Care.  This Plan of Care lists what services are needed by each individual.  This completely customized plan is developed and reviewed annually with the individual served, their parent/guardian, and the case manager/coordinator.


Administration & Locations

Fort Smith Waiver Administration is located in the Elvin and Sally Frick Bost Community Center at 5812 Remington Circle. This facility, opened in October 2005, provides a home for case management and coordination for direct care staff as well as a training facility. The facility was expanded in August 2008, to more fully served individuals who choose Bost.

We have Waiver offices in Fort Smith, Rogers, Harrison, Booneville, and Russellville.


For more information about the Medicaid Waiver Program contact:

Trish Hice, Fort Smith Waiver Director, Ph:  479-478-5662, thice@bost.org

James Maginot, Fort Smith Waiver Director , Ph: 479.478.5596, jamaginot@bost.org

Lindsey Gipson, NWA Waiver Director, Ph:  479.717.2374, lcgipson@bost.org

Jennifer Paterak, SC Waiver Director, Ph:  479-967-3335, jpaterak@bost.org

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