Home and Community Based Services (HCBS) Waivers
Waiver programs for home and community-based care
Overview
Waiver programs offer people who meet an institutional level of care the opportunity to receive care at home or in the community instead of in a facility.
Alaska operates five Medicaid Home and community-based service waivers. They are:
- Alaskans Living Independently Waiver (ALI)
- Alaskans with Physical and Developmental Disabilities Waiver (APDD)
- Children with Complex Medical Conditions (CCMC)
- Intellectual and Developmental Disabilities Waiver (IDD)
- Individualized Supports Waiver (ISW)
The Waiver Programs are described below.
Who qualifies?
- Medicaid Eligibility: Applicants must meet Medicaid income and resource limits, determined through an interview and application with the Division of Public Assistance (DPA).
- Level of Care Requirement: Applicants must be assessed and meet the level of care (LOC) requirements, determined by SDS Intake and Assessment Unit or the SDS Intellectual and Developmental Disabilities (IDD) Unit, depending on the program.
How to sign up
Nurses or other trained staff will complete a functional assessment through in-person interviews or video calls. A nurse supervisor checks the results to decide if the person needs nursing facility care. Each applicant gets a copy of their results and care level decision.
How to use
Waiver program options:
There are several waiver programs to help people receive care at home, in their community, or in a nursing facility:
- ALI Waiver: For adults 21+ who need nursing facility-level care
- APDD Waiver: For adults 21+ with developmental disabilities, assessed by the SDS Intellectual and Developmental Disabilities Unit, who also need nursing-level care
- CCMC Waiver: For children and young adults under 22 with medical fragility that need hospital or nursing facility care
- ICF/IID Waiver: For people with intellectual disabilities, assessed using the ICAP tool
- CCMC or APDD Waiver with Developmental Disabilities: For people with additional developmental disability needs
Inventory for Community and Agency Planning (ICAP)
Evaluators schedule interviews with people who know the person who is applying very well and ask them questions to find out more about their situation and needs.
To qualify for ICF/IID level of care (LOC), applicants must score below a specific age-related measure. Each assessment is reviewed to confirm the LOC determination. Applicants receive a copy of the results.
IDD Waiver: Annually, 50 individuals are chosen from the waitlist to apply.
ISW Waiver: A waitlist will begin once the federally approved participant limit is reached. Participants must agree to a total cost cap for services to join.
People that are eligible can get services like respite care, chores, residential living, care coordination, and environmental modifications. These services are planned by the participant’s team and approved by SDS through a submitted support plan.